I-125 seeds with chemotherapy for progressive non-small-cell lung cancer after first-line treatment: a meta-analysis

Abstract

Background Continuing therapy for aggressive non-small-cell lung cancer (NSCLC) after first-line treatment (FLT) is challenging. The clinical efficacy of second-line chemotherapy (SLCT) for progressive NSCLC is limited. In this meta-analysis, we aim to evaluate the clinical efficacy of the combination of I-125 seeds brachytherapy (ISB) and SLCT in progressive NSCLC after FLT. Methods The PubMed, Embase, Cochrane Library, CNKI, Wanfang, and VIP databases were screened for relevant publications until September 2021. Meta-analyses are conducted by RevMan 5.3 and Stata 12.0. Results Our meta-analysis encompassed 6 studies (4 retrospective studies and 2 randomized controlled trials), which included 272 patients that underwent ISB with SLCT (combined group) and 257 patients that received SLCT alone (chemotherapy alone group). The complete response (24.7% vs. 7.0%, P < 0.00001), treatment response (65.7% vs. 38.1%, P = 0.0002), and disease control (95.2% vs. 80.4%, P < 0.00001) rates are markedly elevated for patients receiving combined therapy versus those receiving chemotherapy alone. Moreover, pooled progression-free survival (P = 0.0001) and overall survival (P < 0.00001) were remarkably extended for patients that received the combination therapy, while no obvious differences were detected in the pooled myelosuppression (39.0% vs. 30.6%, P = 0.05) and gastrointestinal response (38.5% vs. 35.9%, P = 0.52) rates between 2 groups. Significant heterogeneity was found in the endpoints of the treatment response and progression-free survival. Conclusions This meta-analysis demonstrated that ISB could enhance the clinical efficacy of SLCT in patients with progressive NSCLC after FLT without inducing major toxic side effects.

Transarterial chemoembolization with 125I seed insertion for multifocal hepatocellular carcinoma

“…The potential of combined treatment to manage the disease over the long term was demonstrated by the longer OS and PFS intervals compared to with TACE alone. 125 I seeds can eliminate tumor tissues while enhancing tumor chemosensitivity to improve tumor control in the long term ( 20 ). Cox regression analysis revealed that using TACE alone was linked to decreased OS and PFS.…”

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“…Pooled progression-free and OS (both P < .001) were also higher in the combined group with comparable myelosuppression rates and gastrointestinal response. 80 …”

Innovative Invasive Loco-Regional Techniques for the Treatment of Lung Cancer

“…It is essential to mention that these survival rates are speculated to be higher in early-stage NSCLC, in which there is no metastatic disease. Several clinical studies investigated the effect of brachytherapy as an adjuvant therapy combined with other modalities such as chemotherapy, radiofrequency ablation and epidermal growth factor receptor tyrosine kinase inhibitors [ 28 , 29 , 30 , 31 , 32 ]. The addition of brachytherapy to the other modalities showed an increased effect, OS, PFS and QOL.…”

“…[ 31 ] RCT NSCLC IIIB, IV BT EGFR-TKI 54 54 EGFR-TKI n/a Chen, E. [ 26 ] Meta-analysis NSCLC Early-stage BT 308 n/a Chen, S. [ 28 ] RCT NSCLC I, IIA, III BT RFA 15 15 RFA n/a Chen, Z.K. [ 29 ] Meta-analysis NSCLC III, IV BT ChT 259 257 ChT n/a Endobronchial radiofrequency ablation Author Study Type Stages Groups N Adj. Th.…”