Dosimetric comparison of CT-guided iodine-125 seed stereotactic brachytherapy and stereotactic body radiation therapy in the treatment of NSCLC

Li, Ranran; Zhang, Ying; Yuan, Yuan; Qi, Lin; Dai, Jianjian; Xu, Ruicai; Hu, Xudong; Han, Mingyong

doi:10.1371/journal.pone.0187390

Cited by 9 publications

(10 citation statements)

References 27 publications

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“…Compared with SBRT, brachytherapy can generate a comparable dose within the planning target volume (PTV D 90 [104.73 ±2.10 Gy vs. 107.64 ±2.29 Gy], mean volume receiving 100% of the prescription dose (V 100% ) [91.65% vs. 92.44%, p = 0.410], while the organs at risk receive only a very low-dose. The mean lung doses (MLD) in brachytherapy were significantly lower than those in SBRT (1.952 ±0.713 vs. 5.618 ±2.009, p < 0.0001) [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

How many times 125I seed implantation brachytherapy can be repeated for pulmonary metastases: clinical efficacy and complications

Zhang

Xie

et al. 2019

jcb

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PurposeThe aim of the study was to determine how many times iodine-125 (125I) seed brachytherapy (ISB) for recurrent pulmonary metastases (RPM) can be done, and the clinical efficacy and complications of repeated ISB in RPM treatment.Material and methodsBetween September 2013 and August 2018, 18 patients with RPM, after conventional chemotherapy, radiotherapy, and trans-arterial chemoembolization, received CT-guided repeated ISB. Patients were followed up, and local control, survival, and post-operative complications were analyzed retrospectively. The Kaplan-Meier method was used for survival analyses.ResultsEighty-two metastases in 18 patients were treated with ISB, with 71 implantations (mean number of implantations per patient, 4; range, 3-8). The total number of implanted 125I seeds was 1,220 (mean number per patient, 68; minimum, 40; maximum, 110). The mean value of D90 for ISB was 138 Gy. Local control was 91.46%, 90.24%, and 89.02% at 1, 3, and 6 months after ISB, respectively. After repeated ISB, good local control was achieved, and all patients were discharged from hospital within 3 days. One month after, six metastases of large diameter were treated with ISB; computed tomography revealed level 1 radioactive injury to the lungs, but special treatment was not administered. Post-operative renal, hepatic, and vascular functions were normal.ConclusionsISB for RPM is safe and efficacious. RPM treatment seems not to be limited by number of times ISB could be repeated; at least up to 8 times for different sites of lung.

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Section: Discussionmentioning

confidence: 99%

How many times 125I seed implantation brachytherapy can be repeated for pulmonary metastases: clinical efficacy and complications

Zhang

Xie

et al. 2019

jcb

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“…Researchers have often compared permanent seed brachytherapy to SBRT, with the perception that SBRT would eventually replace brachytherapy; however, it is clear that only brachytherapy can provide the combination of ultimate conformality and minimum normal tissue dose. Seeds might prove worthy opponents to SBRT, with evidence in early lung cancers showing similar target coverage, but a much lower critical organ dose 80 …”

Section: Resultsmentioning

confidence: 99%

“…The higher initial cost of seed brachytherapy, as well as the fact that the technical advancements have lagged behind similar advances in EBRT, require further attention in future studies. Concerns have been raised about the plateau reached in EBRT techniques across different forums, and it might be appropriate to revert to basic radiotherapy, such as seed brachytherapy, to achieve comparable results to SBRT techniques and even proton therapy 80,84 …”

Section: Discussionmentioning

confidence: 99%

Low dose rate permanent seed brachytherapy: tracing its evolution and current status

Banerjee

Kataria

Goyal

et al. 2020

Precision Radiation Oncology

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A recent surge in publications on low dose rate permanent seed brachytherapy prompted us to review the currently available literature in order to provide a summary of the therapy. To this end, we composed a comprehensive review on the available English language publications in PubMed, EMBASE, and Google Scholar. The general principles of seed brachytherapy are discussed, along with radiobiology and technical aspects. Seed brachytherapy has been increasingly used in various sites for primary treatment, and is considered to be particularly useful in cases of reirradiation and otherwise untreatable malignancies. In recent decades, there have been considerable advances in the technology used in seed brachytherapy, including steps to prevent the migration of seeds, reduce personnel exposure to radiation, and use of sophisticated 3-D planning for better dosimetric results, which have ultimately translated into better clinical outputs. Technical advances in seed brachytherapy have lagged behind those in external beam radiotherapy and high dose rate brachytherapy; however, there is renewed interest due to encouraging clinical results in the primary setting, as well as reirradiation for recurrent disease across several sites.

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“…The ability to implant low energy sources directly into tumors results in a rapid fall-off of dose peripherally, with total sparing of adjacent normal tissues. A study comparing dosimetries of SBRT versus permanent seed brachytherapy for NSCLC showed extremely low-dose to normal tissue with brachytherapy compared with SBRT, but with lower conformity (CI) and heterogeneity (HI) indices in the brachytherapy group [20]; V 100 and D 90 (BED Gy) prescription doses were nearly identical in both treatments (91.6% and 92.4%; 104.7 Gy and 107.6 Gy, respectively), but V 150 was substantially higher with brachytherapy (64.7% and 0%) [20].…”

Section: Discussionmentioning

confidence: 99%

A novel approach for salvage treatment of non-small-cell lung cancer: percutaneous CT fluoroscopy-guided permanent seed brachytherapy for salvage treatment of lung cancer: long-term results of a case series

Doggett

Chino

Lempert

2019

jcb

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Purpose We sought a curative technique to treat recurrent or primary non-small cell lung cancer (NSCLC) with a minimally invasive outpatient technique that could be repeated multiple times, had minimal pulmonary toxicity, and was readily available in the community setting. Percutaneous outpatient computed tomography (CT) fluoroscopy-guided permanent seed brachytherapy fits these criteria. Material and methods Eight lesions in five patients (three patients had two lesions each) with NSCLC were treated using outpatient percutaneous CT fluoroscopy-guided palladium-103 seed brachytherapy. At initial presentation, seven lesions had recurred following external beam radiation therapy (EBRT) and initial chemotherapy, and one lesion was treated with brachytherapy as a primary treatment. Results In five patients with eight lesions, there were no recurrences at follow-up from final implant, average follow-up of 58.1 months (range, 15-145 months). There were no acute complications requiring intervention and no long-term complications. One lesion required a second salvage implant 10 months after first implant. This lesion’s original salvage D 90 was but 90% and repeat implant achieved a D 90 of 273%. This salvaged site had not recurred at 43-month follow-up after the second salvage implant. Conclusions Percutaneous CT fluoroscopy-guided permanent seed brachytherapy is a safe, efficacious, and cost effective primary and salvage treatment for lung cancer. CT-fluoroscopy resources are readily available in the community and are an effective alternative to stereotactic body radiation therapy (SBRT), intensity-modulated radiation therapy (IMRT)/proton beam, radiofrequency ablation (RFA), and cryoablation (CA). Percutaneous CT fluoroscopy-guided permanent seed brachytherapy has an equivalent or better local control rate, a lower resource cost, and a far lower integral radiation dose than other therapies. We believe this is the first published article documenting the curative potential of percutaneous CT fluoroscopy-guided permanent seed brachytherapy for recurrent NSCLC with long-term follow-up. High D 90 doses appear to be required to achieve complete response. Further studies are essential to confirm these findings.

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Dosimetric comparison of CT-guided iodine-125 seed stereotactic brachytherapy and stereotactic body radiation therapy in the treatment of NSCLC

Cited by 9 publications

References 27 publications

How many times 125I seed implantation brachytherapy can be repeated for pulmonary metastases: clinical efficacy and complications

How many times 125I seed implantation brachytherapy can be repeated for pulmonary metastases: clinical efficacy and complications

Low dose rate permanent seed brachytherapy: tracing its evolution and current status

A novel approach for salvage treatment of non-small-cell lung cancer: percutaneous CT fluoroscopy-guided permanent seed brachytherapy for salvage treatment of lung cancer: long-term results of a case series

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