¹²⁵I brachytherapy of locally advanced non-small-cell lung cancer after one cycle of first-line chemotherapy：a comparison with best supportive care

Abstract

ObjectivesThe objective of this study was to assess the efficacy of computed tomography (CT)-guided 125I brachytherapy alone in improving the survival and quality of life of patients with unresectable locally advanced non-small-cell lung cancer (NSCLC) after one cycle of first-line chemotherapy.Patients and methodsSixteen patients with locally advanced NSCLC were treated with CT-guided 125I brachytherapy after one cycle of first-line chemotherapy (group A). Sixteen patients who received only best supportive care (group B) were matched up with the patients in group A. Primary end point included survival, and secondary end point included assessment of safety, effectiveness of CT-guided 125I brachytherapy, and improvement in the quality of life.ResultsThe two groups were well balanced in terms of age, disease histology, tumor stage, tumor location, and performance status (P>0.05). The median follow-up time was 16 months (range, 3–30). The total tumor response rate was 75.0% in group A, which was significantly higher than that in group B (0.0%) (P<0.01). The median progression-free survival time was 4.80 months for patients in group A and 1.35 months for patients in group B (P<0.001). Kaplan–Meier survival analysis showed that the median survival time of group A was 9.4±0.3 months versus 8.4±0.1 months in group B (P=0.013). Tumor-related symptoms of patients were significantly relieved, and the quality of life was markedly improved in group A than in group B.ConclusionCT-guided 125I brachytherapy improved the survival of patients with locally advanced NSCLC and quality of life after one cycle of first-line chemotherapy compared with best supportive care.

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

“…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).…”

“…Surgery, external beam radiotherapy (EBRT) or chemotherapy used alone or in combination are the standard treatments recommended for patients with NSCLC (4). 125 I brachytherapy performed by implantation of 125 I radioactive seeds in the tumors can induce extensive necrosis of tumors and improve the quality of life of patients (5). 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).…”

“…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).…”

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

“…After treatment, the caner-related symptoms of patients were obviously improved, so the ECOG performance scores were pronouncedly improved which was observed in 18 patients in our study. Song et al indicated that iodine-125 seed implantation not only showed noteworthy superiority in ameliorating cancer-related symptoms but also signi cantly improved QOL of patients diagnosed as advanced NSCLC (34). It is remarkable that the combined-modality therapy was able to signi cantly relieve cancer-related pain and improve ECOG scores which could contribute to improve QOL.…”

Chinese Expert Consensus Workshop Report: Guideline for permanent iodine‐125 seed implantation of primary and metastatic lung tumors

“…Indications Primary lung cancer: (i) patient is not a candidate for surgery because of inferior cardiopulmonary function or advanced age 24,25 (ii) patient refused surgery; (iii) patient is not a candidate for surgery because of recurrence after surgery 22 (iv) a residual or progressive tumor is observed after surgery, radiotherapy, or chemotherapy 26 (v) thermal ablation or surgery failed to distinguish the tumor-free boundary; 27,28 (vi) Karnofsky Performance Score (KPS) > 60 and predicted life span > 6 months; and (vii) the diameter of largest tumor is < 7 cm. 12 Metastatic lung cancer: (i) the patient has ≤ 3 unilateral lesions ≤ 5 cm in diameter; (ii) if a patient has ≤ 3 bilateral lesions ≤ 5 cm in diameter, these should be treated separately.…”