Limited resection for non-small cell lung cancer: observed local control with implantation of I-125 brachytherapy seeds.
BACKGROUND
Limited resection for lung cancer has been associated with a relatively high incidence of local recurrence. This retrospective study evaluates the impact of implanting radioactive iodine-125 (125I) seeds along the resection margin in these patients.


METHODS
Thirty-three patients with lung cancer who were not candidates for lobectomy or pneumonectomy underwent a limited resection of 35 primary non-small cell lung cancers. 125I brachytherapy seeds were implanted along the resection margin to reduce the risk of local recurrence. Survival using the Kaplan-Meier method and sites of recurrence were documented. Follow-up ranged from 20 to 98 months (median, 51 months).


RESULTS
The 5-year survival was 47% for all patients. For patients with T1N0 tumors, it was 67%, and for patients with T2N0 tumors, it was 39%. However, the cancer-specific survivals were 77% and 53% for patients with T1N0 and T2N0 tumors, respectfully. Ten patients experienced recurrence, with two local (at the resection margin) and six regional recurrences (five mediastinum, one chest wall). Both local recurrences and one regional recurrence occurred in the 19 patients with T1N0 tumors.


CONCLUSIONS
125I seed implantation along the resected margin for compromised patients undergoing limited resection of lung cancer results in a relatively low incidence of local recurrence and may prolong survival.
Lee
Winnie
W
Division of Cardiothoracic Surgery, Department of Radiation Oncology, New England Medical Center, Boston, Massachusetts, USA.
Daly
Benedict D T
BD
DiPetrillo
Thomas A
TA
Morelli
Donna M
DM
Neuschatz
Andrew C
AC
Morr
Jody
J
Rivard
Mark J
MJ
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage*; D008175:Lung Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D012189:Retrospective Studies; D015996:Survival Rate
D007457:Iodine Radioisotopes