Trans-bronchoscopy with implantation of 125I radioactive seeds in patients with pulmonary atelectasis induced by lung cancer

Abstract

Abstract.To evaluate the role of low-dose-rate interstitial brachytherapy using trans-bronchoscope 125 I radioactive seeds implantation in patients with pulmonary atelectasis induced by lung cancer, in terms of feasibility, safety, quality of life (QOL), and survival time. Between April 2008 and June 2011, 15 patients from two medical institutions that had obstructive pulmonary atelectasis caused by inoperable lung cancer were assigned to receive 125 I implantation endoluminal brachytherapy by bronchoscopy. Subsequent to the implantation of 125 I seeds, the outcomes were measured in terms of procedure success rate, reopening of atelectasis, complications associated with the procedure, Karnofsky performance status (KPS) scores and survival time. The surgical procedure was successfully performed in all 15 patients. No procedure-associated mortality occurred and the complications were mild and considered acceptable. Irritable cough and temporary increase of hemoptysis occurred in 11 (73.3%) and 10 (66.7%) patients respectively, and were the most common complications. The pulmonary atelectasis reopening rate subsequent to the procedure was 86.7, 76.9, 80.0, 75.0 and 50.0% at 2, 6, 12, 18 and 24 months, respectively. The KPS score significantly improved following the implantation of 125 I seeds and the duration of improvement ranged between 3 and 27 months. The median and mean survival times were 15.6 and 16 months, respectively. Actuarial survival rates at 6, 12 and 24 months after the procedure were 86.7, 66.7 and 13.3%, respectively. In patients with advanced lung cancer and those presenting with obstructive pulmonary atelectasis, treatment with intraluminal implantation of 125 I seeds is a safe and effective therapy option with easy accessibility.

Feasibility and Efficacy of Microwave Ablation Combined with Iodine-125 Seed Implantation in Local Control of Recurrent Retroperitoneal Liposarcomas: Initial Clinical Experience

“…Nerve injury, defined as limb paresthesia or leg weakness, was detected in one patient, who recovered completely in 2 months without special therapy. Numerous studies had proven the safety of 125 I seed implantation brachytherapy . In this study, fewer complications were observed in the 125 I seed implantation procedure than in the MWA procedure.…”

“…Achieving a complete response (CR) is important when local therapy is performed in selected patients. Iodine‐125 ( 125 I) radioactive seed implantation has been shown to be efficient in treating many types of malignant tumors , especially in complex situations . This study focused on whether 125 I seed implantation after MWA could improve local control in selected patients with rRPLs.…”

Computed tomography-guided implantation of 125I radioactive seeds in patients with malignant airway compression induced by advanced lung cancer: effectiveness and safety in 40 patients

“…Recently, 125 I radioactive seed implantation had proved its efficacy in various malignant tumors [10,11,12,13]. The results of Lu et al revealed that trans-bronchoscopy 125 I radioactive seed implantation brachytherapy could improve the survival and quality of life of patients with pulmonary atelectasis induced by intralumi-nal airway obstruction [14]. However, studies on the efficacy of computed tomography (CT)-guided 125 I radioactive seed implantation in patients with malignant airway compression (MAC) related to advanced lung cancer are still rare.…”

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

“…Lung tumors located adjacent to the hilus, large vessels, or heart cannot be treated via radical resection …”