To evaluate the efficacy and safety of 125I seed implantation in SCLC as second line therapy

Abstract

This study aimed to evaluate the efficacy and safety of iodine 125 (125I) radioactive seed implantation for small cell lung cancer at the limited stage of relapse as second line therapy. We collected 6 patients with recurred limited stage small cell lung cancer, who got pathological diagnosis after a bronchoscopic biopsy and then received standard first line treatment, combined chemotherapy and radiotherapy, including prophylactic cranial irradiation. These recurred small cell lung cancer patients got 125I seed implantation treatment as second line therapy, if the treatment not good responsive or the disease got rapid progress, we used the second line chemotherapy as salvage treatment. Clinical data of these patients were collected and short-term effects were observed. The follow-up period lasted for 42 months. All the patients tolerated the procedure of 125I radioactive seed implantation very well. We followed up the patients to 42 months. Five patients got complete remission and 1 patient got partial remission at 1 month after implantation. The objective response rate was 100%. The median survival time was 26 months. And median progression-free survival was 12 months after 125I treatment. And about the complications, 1 patient suffered from the light aerothorax, 1 patient had a little hemoptysis. Our study showed that 125I seed implantation as second line regimen in small cell lung cancer that recurred locally after first line treatment was effective and safe. That could improve the overall survival and progression-free survival only comparing to the second line chemotherapy. Therefore 125I seed implantation as brachytherapy protocol is a promising method and can be applied as second line treatment to control the locally recurred small cell lung cancer.

The efficacy and safety of percutaneous CT-guided iodine-125 brachytherapy combined with standard chemotherapy and brachytherapy alone for lung malignant nodule: a retrospective comparative cohort study

“…Brachytherapy has been widely introduced in thoracic malignancy treatment. Adjuvant brachytherapy after sublobar resection, high-dose-rate endobronchial seed implantation, and CT-guided percutaneous brachytherapy are the common application settings of radiation seed in the thorax ( 8 ), with use in thymomas and mediastinal tumors being reported in a few studies ( 11 - 20 ). Internal radiotherapy with radiation seed has also shown benefit in prostate cancer and liver neoplasms ( 21 , 22 ).…”

“…For advanced patients, the prognosis is closely related to recurrence ( 2 ). Brachytherapy itself can be seen as an effective compensatory strategy for bulky lesions in terms of standard chemotherapy treatment ( 11 , 24 , 25 ). Due to the distance effect, the 125 I seed has limited control at the edge of its activity range.…”

“…However, general survival outcomes for late-stage lung cancer remain poor, with poor local control being one of the major causes of treatment failure in advanced cases ( 2 ). Brachytherapy has its advantages in treating localized solid tumors ( 10 , 11 ). There have been some studies that have demonstrated that it can be used in combination with other treatments to achieve good safety and efficacy.…”