Comparison between sublobar resection and 125Iodine brachytherapy after sublobar resection in high-risk patients with Stage I non–small-cell lung cancer

Limited resection followed by intraoperative seed implantation is comparable to stereotactic body radiotherapy for solitary lung cancer

“…In patients with a previous history of lobectomy/pneumonectomy or poor pulmonary function, ''less'' surgery (ie, wedge resection or segmentectomy) has been used, and radioactive seeds have been added to the resection site to increase the chances of achieving local control. [7][8][9] Alternatively, extracranial SBRT is used instead of a surgical option. To our knowledge, no previous studies have compared these 2 therapeutic options (IOS implantation and SBRT).…”

“…Reported local control rates using intraoperative brachytherapy with wedge resection have been in the range of 90% to 98% and have produced local control rates equivalent to those produced with lobectomy. [7][8][9] To our knowledge, this is the first report comparing the 2 treatment modalities. The data suggest that both treatment modalities offer efficacy in terms of local control.…”

“…[7][8][9] IOS implantation resulted in a 2% local recurrence rate compared with 19% in patients who underwent wedge resection alone 7 for early stage nonsmall cell lung cancer. Radiofrequency ablation is a relatively new procedure that allows local treatment without parenchymal damage.…”

Lung Cancer Brachytherapy: Robotics-Assisted Minimally Invasive Approach

“…The recent increase in MIS has also renewed an interest in the role of adjuvant brachytherapy for lung cancer [52][53][54][55][56][57][58][59]. Following resection of small lung tumours (T1N0), intraoperative I-125 seeds have been implanted with Vicryl ® mesh along the resection margins [52,53,57].…”

“…Intentional sublobar resection for small lung cancers (T1N0) has been performed using minimally invasive techniques with equivalent results [68][69][70][71][72][73][74]. Recently, intraoperative brachytherapy on the resection staple line has been shown to significantly decrease the local recurrence rates associated with these limited resections [52,54,55,57,59]. Our experience with intraoperative brachytherapy reveals this technique can achieve considerable lung volume sparing for irradiation to normal tissue with less than 2% lung volume receiving 20 Gy 1 (Fig.…”