Computed tomography-guided implantation of 125I radioactive seeds in patients with malignant airway compression induced by advanced lung cancer: effectiveness and safety in 40 patients

Abstract

To evaluate the safety and efficacy of computed tomography (CT)-guided 125 I radioactive seed implantation in patients with malignant airway compression induced by advanced lung cancer. Material and methods: Between June 2015 and June 2018, 40 patients from three medical institutions with malignant airway compression induced by advanced lung cancer were treated with 125 I seed implantation. The outcomes were measured in technical success and safety, objective response rate, complications, Karnofsky performance status (KPS) score, and survival time. Results: All 40 patients successfully underwent implantation procedure. No procedure-associated death occurred. The most common complications were irritable cough, temporary hemoptysis, chest pain, fever, and pneumothorax, which occurred in 26 (65.0%), 31 (77.5%), 12 (30.0%), 15 (37.5%), and 11 (27.5%) patients, respectively. The objective response rates were 100%, 100%, 100%, 87.5%, and 83.3% at the 3 rd , 6 th , 12 th , 24 th , and 36 th months post-procedure, respectively. The KPS score significantly improved at post-procedure. Median survival time was 25.1 months. Actuarial survival rates were 100%, 60%, and 15% at the 12 th , 24 th , and 36 th months after the procedure, respectively. Conclusions: For patients with malignant airway compression induced by advanced lung cancer, implantation with 125 I seed is a safe and effective alternative treatment option.

CT-guided trans-sternal 125I seeds implantation for masses in the anterior or middle mediastinum

“…In the literature, both approaches have been compared mainly for prostate cancer treatments and to date, brachytherapy has been reported to be su-perior to IMRT [4][5][6][7]. The efficacy and safety of computed tomography (CT)-guided 125 I implantation for the treatment of mediastinal metastases and primary mediastinal malignant tumors has also been proven [8][9][10]. However, the anatomical structures in the mediastinum are complex, and lesions are often adjacent to the superior vena cava, aorta, and other great blood vessels.…”

CT-guided radioactive 125I seeds brachytherapy for lung oligometastases from colorectal cancer: initial results

“…This highly conformal brachytherapy can ensure accurate attack on the tumor while simultaneously protecting the surrounding normal tissues and organs at risk (OAR) to the greatest extent. RISB has been widely used in the local treatment of prostate cancer [ 8 ], lung cancer [ 9 ], pancreatic cancer [ 10 ], esophageal cancer [ 11 ], biliary cancer [ 12 ] and so on. What’s more, RISB for prostate cancer and brachytherapy stent loaded with 125 I seeds for malignant esophageal obstruction is recommended by some guidelines from the European Endoscopic Society and the Chinese Society for Esophageal Cancer Radiotherapy [ 13 , 14 ].…”

Animal study of a newly designed metal airway brachytherapy stent loaded with radioactive 125I seeds

“…It is well known that external beam radiotherapy (EBRT) can signi cantly inhibit stent intimal hyperplasia and tumor growth, but unfortunately, 40% of patients cannot tolerate the associated complications 3 . 125 I seed brachytherapy is an effective local regimen to inhibit normal cell proliferation and malignant tumors to a certain extent to prevent excessive proliferation of granulation tissue and has been applied to solid tumor treatment for many years, such prostate cancer 4 , lung cancer 5 , liver cancer 6 , and bone metastasis 7 . To solve the above problems, Chinese scholars have combined radioactive 125 I seeds with conventional metal airway stents to form a brachytherapy stent (BS) inspired by esophageal 125 I brachytherapy stents 8 and biliary 125 I brachytherapy stents 9 , which have been reported in a previous clinical study.…”