Effectiveness of 125I seed implantation in the treatment of non‑small cell lung cancer during R2 resection

Abstract

The aim of the present study was to investigate the effectiveness of 125I particle implantation during R2resection for non-small cell lung cancer (NSCLC). Data from 23 patients with NSCLC and macroscopic residual diseasefollowing surgery (R2 resection) between March 2010 and May 2014 were retrospectively analyzed. Among these patients, 12 patients [4 with T-residual disease (incomplete resection of primary tumor but complete dissection of regional lymph node), 8 with N-residual disease (complete resection of primary tumor but incomplete resection of metastatic regional lymph node)] underwent 125I particle implantation during the operation, while the other 11 (4 with T-residual disease and 7 with N-residual disease) received postoperative conventional radiotherapy. The local control rate, overall survival, and distant metastasis were evaluated. Additionally, the efficacy and safety of brachytherapy using 125I particle implantation during surgery for locally advanced NSCLC were investigated. The 23 patients were followed up for 3–40 months. For the 125I group, the 2-year local control rate was 100%, and the median survival time was 24 months. The 1–2-year survival rates were 83.3 and 58.33%, respectively. For the postoperative radiotherapy group, the median survival time was 12 months, andthe 1- and 2-year survival rates were 54.5 and 27.7%, respectively. No statistically significant difference in 2-year survival rates was detected between the two treatment groups, but the particle implantation group exhibited a higher survival rate trend. For patients with T-residual disease, the survival rate was higher for the 125I seed implantation group compared with the postoperative radiotherapy group. However, there was no significant difference in the rates of metastasis between the two groups for patients with N-residual disease. Therefore, intraoperative implantation of 125I particles during R2 resection of NSCLC may be a safer and more reliable method to reduce the local recurrence rate compared with conventional radiotherapy. Although not statistically significant, the overall survival rate of patients in the 125I seed implantation group was higher compared with the postoperative radiotherapy group.

Analysis on the Efficacy of Bronchial Artery Chemoembolization Combined with 125I Seed Implantation in the Therapy of Advanced Non-Small-Cell Lung Cancer Based on the Medical Database

“…Another study confirmed that 125I seed implantation can effectively improve the disease control rate relative to conventional radiotherapy and chemotherapy in lung cancer patients [7]. 125I seed implantation is considered as an effective therapeutic option for patients with advanced lung cancer who have failed first-line chemotherapy [8,9]. In view of this, the results showed that the disease remission rate was 41.18% with 125I seed implantation.…”

“…Step-bystep radiotherapy and chemotherapy have killing effects on T lymphocytes and normal tissue cells when killing cancer cells [17]. 125I seed implantation under the guidance of TPS system can advance accurate and precise radiation range; in addition to ensure the effective radiation dose in cancer target area, the damage to surrounding organs and tissues is small, which is beneficial to improve immune function of the body [9]. Besides that, BACE, as a local interventional chemotherapy, injects chemotherapeutic drugs into the lesion through a microcatheter and embolizes the target vessel with gelatin sponge; in addition to achieve antitumor effect, BACE has little influence on T lymphocytes and normal tissue cells and can effectively regulate immunity while inhibiting tumor growth [18].…”

Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

“…These lymph nodes can contribute to metastatic spread, thereby affecting the long-term survival of patients [4,5,[26][27][28][29][30]. 125 I brachytherapy, with a higher local concentration of radiotherapy, is particularly well suited for the treatment of retroperitoneal metastasis [31][32][33][34]. Yao [19] et al reported 17 patients with 19 retroperitoneal metastatic lymph nodes who received 125 I brachytherapy with an overall effective rate of 100%.…”

Implantation of computed tomography-guided Iodine-125 seeds in combination with chemotherapy for the treatment of stage III non-small cell lung cancer

“…For stage IIIA and IIIB patients, the 5-year survival rates were 19.63% and 10.0%, with median survival time of 26.67 and 24.59 months, respectively. Huang [ 21 ] has reported 32 patients of stage IIIB NSCLC treated with radical resection and implantation of radioactive 125 I seeds; their 1- and 3-year survival rates were 63.8%, and 31.9%, respectively. At present, many studies have reported the significant short-term therapeutic efficacy of radioactive seed implantation for lung cancer, but only a few reports have discussed its long-term therapeutic efficacy; these studies include only a small number of cases.…”