Iodine¹²⁵ interstitial brachytherapy in the treatment of carcinoma of the lung

Abstract

In a prospective study, 14 patients with primary non-oat cell lung carcinoma were treated with intraoperative Iodine125 (I125) implantation of the lung tumor via lateral thoracotomy or median sternotomy. Staging mediastinal node dissection was performed in each case. Patients were selected when wedge or segmental resections were not technically feasible, such that lobectomy or completion pneumonectomy would have been required or pulmonary function studies were poor. Doses ranged from 8,000 cGy at the periphery to 20,000 cGy at the center. With a minimum 12 month follow-up, mean and median survivals were 16.7 and 15.1 months, respectively. Local control was achieved in 10 of 14 patients (71%) with all local failures occurring in pathologic stage III patients. When separated according to tumor size, local control was obtained in six of seven tumors of less than 3 cm and four of five tumors of 3-5 cm. Both cases with masses greater than 5 cm failed locally. There was one operative mortality and two postoperative complications. All other patients were discharged within one week of surgery. There was no radiation pneumonitis. I125 lung brachytherapy is an excellent alternative treatment for T1 and T2 tumors when medical conditions preclude curative resection.

Toxicity of photodynamic therapy after combined external beam radiotherapy and intraluminal brachytherapy for carcinoma of the upper aerodigestive tract

“…Intraluminal treatment uses a physical advantage because it is able to prescribe a high dose of radiation to a well-de®ned area while placing the applicator under direct vision at endoscopy. Normal tissues are spared, and consequently, complication rates are relatively low [11,12]. For example, Fleischman and associates had three complications in a series of 14 patients with locally advanced non-small cell lung cancer treated with this technique [12].…”

Lung Cancer Brachytherapy: Robotics-Assisted Minimally Invasive Approach

“…Interstitial brachytherapy allows more precise delivery of radiation and easier adaptation to the tumour shape than is possible with external radiation [20,36], and a higher dose can be delivered to the tumour volume with less damage to the normal lung. The seeds are implanted into cancerous tissue using long and hollow needles, which have small outer diameters and at least one sharp end to allow penetration through the tissue.…”

Electromagnetic navigation improves minimally invasive robot-assisted lung brachytherapy

“…Interstitial brachytherapy is an alternative form of radiation treatment that places a radioactive source near or into a tumor. The delivery of radiation is more precise, and larger doses can be concentrated into the tumor while minimizing damage to normal tissue [2,3].…”