Repeated iodine-125 seed implantations combined with external beam radiotherapy for the treatment of locally recurrent or metastatic stage III/IV non-small cell lung cancer: a retrospective study

Li, Wei; Dan, Gang; Jiang, Jianqing; Zheng, Yifeng; Zheng, Xiushan; Deng, Dan

doi:10.1186/s13014-016-0688-5

Cited by 21 publications

(22 citation statements)

References 16 publications

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“…1A and 2C) and the rest were treated with freehand implantation. The median number of seeds implanted was 57 (range, 14-100) and the median number of needles was 5 (range, [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Postoperative dosimetric measurements demonstrated that the actual D90 ranged between 79 and 148 Gy (mean D90, 113 Gy; Table SI).…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies have demonstrated that iodine-125 ( 125 I) seed implantation brachytherapy exhibits good clinical results as a minimally invasive and effective treatment for a variety of tumors, such as pancreatic or liver cancer and gynecologic malignancies (6)(7)(8). Recently, 125 I brachytherapy has been used for the treatment of lung cancers; however, most of these studies focused on assessing the effectiveness of 125 I brachytherapy combined with chemotherapy or radiotherapy (3,5,9,10).…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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“…Nevertheless, it is difficult to deliver a sufficient radiation dose to tumors using external beam radiotherapy alone because of the obstruction of surrounding tissues (12). Radioactive seed implantation has been reported to be successfully applied for treating inoperable solitary lung cancers, while avoiding excessive radiative exposure to surrounding normal tissues (13), such as iodine-125 ( 125 I) seed implantation. However, there still remains illusiveness whether 125 I radiation can improve the resistance of NSCLC to immunotherapy.…”

Section: Introductionmentioning

confidence: 99%

Combination of pembrolizumab and 125I attenuates the aggressiveness of non‑small cell lung cancer

et al. 2020

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Non-small cell lung cancer (NSCLC) is the leading cause of cancer-associated mortality. Therapies targeting programmed cell death 1 ligand 1 (PD1L1) have promising effects on NSCLC. However, resistance to targeted therapy has become the main problem and the underling molecular mechanism remains unclear. In the present study, the expression of PD1L1 in NSCLC was determined and the association with clinicopathological characteristics was analyzed. A combination therapy was also constructed, including pembrolizumab (Pem) and iodine-125 ( 125 I), which represented an efficient strategy for the treatment of NSCLC. The expression of PD1L1 was upregulated in NSCLC tissues and positively correlated with the Ki-67 index, pathological subtypes and risk stages. A higher level of PD1L1 expression was associated with poorer survival in patients with NSCLC, which could be used as a prognostic indicator. When NSCLC cells were cultured in the presence of Pem and 125 I seeds, the combination treatment significantly abrogated the tumor proliferation and aggressiveness through the inhibition of matrix metalloproteinase-2 and -9 secretion. Flow cytometry analysis revealed pembrolizumab combined with 125 I contributed to a higher rate of apoptosis and cell cycle arrest, indicating that the combination treatment improved the resistance to immunotherapy. Furthermore, the associated molecular mechanism was the dysregulation of ADAM metallopeptidase domain 17. The findings from the present study revealed that PD1L1 could be used as a predictive biomarker, and the application of combination treatment of pembrolizumab and 125 I showed promising effects on NSCLC.Abbreviations: PD1L1, programmed cell death 1 ligand 1; ADAM17, ADAM metallopeptidase domain 17; RT-qPCR, reverse transcriptase-quantitative polymerase chain reaction; PI, propidium iodide; MMP, matrix metalloproteinase; FCM, flow cytometry Key words: non-small cell lung cancer, programmed cell death 1 ligand 1, iodine-125, targeted therapy

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“…Additionally, the incidence of severe irradiation-related adverse effects is signi cantly reduced and the slight complications could disappear soon with supportive care (8). Because of the mentioned advantages, patients including the elderly, have showed great interest and good compliance (14)(15)(16)(17).…”

mentioning

confidence: 99%

Efficacy and Safety Aiming at the Combined-Modality Therapy of External Beam Radiotherapy (40Gy) and Iodine-125 Seed Implantation for Locally Advanced NSCLC in the Elderly

Tian

Liu

Zhang

et al. 2020

Preprint

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Background Our retrospective study aimed to evaluate the efficacy and safety of the combined-modality therapy for tumor invading the chest wall of locally advanced non-small-cell lung cancer (NSCLC) in the elderly. Methods We retrospectively enrolled 21 elderly patients (aged ≥ 60 years) with locally advanced NSCLC diagnosed as tumor invading the chest wall. The prescription dose of the primary tumor adopting external beam radiotherapy (EBRT) was given 40 Gy which was supplemented with iodine-125 seed implantation, meanwhile the lymph nodes of mediastinum undergoing EBRT was given 60 Gy. Follow-up was conducted every 3 months postoperatively. The related analytic parameters were the change of tumor size, the objective response rate (ORR), the disease control rate (DCR), the degree of pain relief, the improvement of physical status and the toxicity. Results The combined-modality therapy could significantly inhibit the local growth of tumor (from 7.84 ± 1.20 to 4.69 ± 1.90 cm) (P < 0.0001), indicating a better validity with an ORR of 71.4% and DCR 90.5%, respectively at 1 year. The cancer-related pain was significantly relieved (P < 0.05) and the physical status were also significantly improved (P < 0.05). There was no procedure-associated death or grade > 2 irradiation-related adverse effect in our study. Conclusions The combined-modality therapy of EBRT with 40 Gy and permanent iodine-125 seed implantation is an efficacious and safe option and may be recommended as a treatment pattern for the elderly of locally advanced NSCLC with tumor invading the chest wall.

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Repeated iodine-125 seed implantations combined with external beam radiotherapy for the treatment of locally recurrent or metastatic stage III/IV non-small cell lung cancer: a retrospective study

Cited by 21 publications

References 16 publications

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

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

Combination of pembrolizumab and 125I attenuates the aggressiveness of non‑small cell lung cancer

Efficacy and Safety Aiming at the Combined-Modality Therapy of External Beam Radiotherapy (40Gy) and Iodine-125 Seed Implantation for Locally Advanced NSCLC in the Elderly

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