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125I Brachytherapy in Locally Advanced Nonsmall Cell Lung Cancer After Progression of Concurrent Radiochemotherapy
Zhanwang Xiang1, Guohong Li, Zhenyin Liu
1From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center (ZX, GL, JH, ZZ, LS, CL, FZ), and Guangzhou Women and Children Health Care Center, Guangzhou, China (ZL).
Computed tomography (CT)-guided Iodine-125 seed implantation offers improved tumor response and progression-free survival for advanced non-small cell lung cancer (NSCLC) patients post-radiochemotherapy. This technique provides symptom relief without increased toxicity.
Area of Science:
- Oncology
- Radiology
- Interventional Pulmonology
Background:
- Locally advanced non-small cell lung cancer (NSCLC) poses treatment challenges, especially after progression during concurrent radiochemotherapy (CCRT).
- Salvage treatment options are crucial for improving outcomes in these patients.
Purpose of the Study:
- To evaluate the safety and efficacy of computed tomography (CT)-guided Iodine-125 (I-125) seed implantation as a salvage therapy for locally advanced NSCLC.
- To compare outcomes between patients receiving CT-guided I-125 seed implantation plus chemotherapy and those receiving chemotherapy alone.
Main Methods:
- Retrospective review of 78 locally advanced NSCLC patients who progressed after one cycle of first-line CCRT.
- Group A (37 patients) received CT-guided percutaneous I-125 seed implantation and second-line chemotherapy.
- Group B (41 patients) received second-line chemotherapy alone.
Main Results:
- Group A demonstrated a significantly higher overall response rate (63.6%) compared to Group B (41.5%) (P=0.033).
- Median progression-free survival time was significantly longer in Group A (8.00 months) versus Group B (5.00 months) (P=0.011).
- While 1- and 2-year overall survival rates were higher in Group A, the difference in median overall survival was not statistically significant (P=0.059). Toxicity profiles were similar between groups, with notable symptom reduction and improved quality of life in Group A.
Conclusions:
- CT-guided I-125 seed implantation is a potentially beneficial treatment for localized advanced NSCLC following CCRT failure.
- The procedure achieves good local control, alleviates clinical symptoms, and improves quality of life without substantially increasing side effects.
- I-125 seed implantation represents a viable option for selected NSCLC patients requiring salvage therapy.
