Efficacy and safety of CT‑guided 125I brachytherapy in elderly patients with non‑small cell lung cancer

Abstract

Non-small cell lung cancer (NSCLC) has become the most common cancer type and the leading cause of cancer-associated mortality worldwide. The aim of the present retrospective study was to evaluate the efficacy and safety of computed tomography (CT)-guided 125 I brachytherapy alone in elderly patients with NSCLC. A total of 26 elderly patients with NSCLC stage I-III who had an inoperable lesion or progressive disease following radio-chemotherapy were treated with CT-guided 125 I seed implantation for lung lesions and included in the present study. The prescribed dose of 125 I brachytherapy was 80-140 Gy, and dosimetric verification was performed immediately after the procedure. The response rate (RR) and local control rate (LCR) were analyzed according to the Response Evaluation Criteria in Solid Tumors (version 1.1). Survival was estimated using the Kaplan-Meier method. Safety and complications were also documented. All patients were aged 65-85 years (median age, 77 years) and successfully completed the procedure, and the median follow-up time was 9.4 months (range, 3-31 months). After a 6-month follow-up, for pulmonary lesions, complete response (CR) was achieved in 11 (42.3%) cases, partial response in 9 (34.6%) cases, stable disease in 4 (15.4%) cases and progressive disease in 2 (7.7%) cases. The 6-month RR and LCR were 76.9 (20/26) and 92.3% (24/26), respectively. The mean overall survival (OS) time was 11.7±7.6 months and the 0.5-and 1-year OS rates were 90.1 and 73.3%, respectively. Tumor-related symptoms in patients were significantly alleviated following the procedure. No severe complications occurred during and after the procedure of 125 I seed implantation. In conclusion, CT-guided 125 I brachytherapy is a feasible, effective and safe therapy and may be considered as an alternative option to surgery and radiotherapy for elderly patients with NSCLC.

A Retrospective Study on Using a Novel Single Needle Cone Puncture Approach for the Iodine-125 Seed Brachytherapy in Treating Patients With Thoracic Malignancy

“…125 I brachytherapy is known to be safe and effective in advanced cancer patients (11)(12)(13)(14)(15)(16)(17), and the multiple-needle parallel puncture method is the most common and widely used treatment regimen for 125 I brachytherapy (11)(12)(13)(14)(15)(16)(17)37). It requires multiple accessible puncture sites without obstruction, and is suitable for tumors with relatively regular shapes.…”

Intra-luminal iodine-125 brachytherapy in patients with esophageal carcinoma and 3/4 dysphagia score: A feasibility study

“…Iodine-125 ( 125 I) brachytherapy (BT) has become an important part of the comprehensive treatment of malignant tumors, such as prostate cancer, lung cancer, liver cancer, and bone metastases, because it involves low-dose continuous irradiation, satisfactory local effects, and strong repeatability [3][4][5][6]. Animal studies confirmed that 125 I BT can significantly inhibit squamous cell carcinoma [7].…”

Assessment of EMF Troubles of Biological and Instrumental Medical Questions and Analysis of Their Compliance with Standards

“…Nevertheless, in the case of devices whose operation is based on electromagnetic fields that could be disturbed by external fields or objects involved in medical instruments near or inside the device, typical examples are static fixed-function wearable measuring tools-e.g., [27][28][29]active organ stimulation tools-e.g., [30,31]-and magnetic resonance imagers (MRI) used in image-guided therapies and interventions. Actually, these image-guided operations can use several types of imagers, e.g., [32][33][34][35][36][37][38]. Among these imagers, only two are free of ionizing radiation: the MRI and ultrasound imager (USI) [34][35][36][37][38].…”