Permanent iodine-125 interstitial planar seed brachytherapy for close or positive margins for thoracic malignancies.
OBJECTIVE
To assess toxicity and outcome following permanent iodine-125 seed implant as an adjunct to surgical resection in cases of advanced thoracic malignancy.


METHODS
An institutional review board-approved retrospective review was performed. Fifty-nine patients were identified as having undergone thoracic brachytherapy seed implantation between September 1999 and December 2006. Data for patient demographics, tumor details, and morbidity and mortality were recorded.


RESULTS
Fifty-nine patients received 64 implants. At a median follow-up of 17 months, 1-year and 2-year Kaplan-Meier rates of estimated overall survival were 94.1% and 82.0%, respectively. The 1-year and 2-year local control rates were 80.1% and 67.4%, respectively. The median time to develop local recurrence was 11 months. Grades 3 and 4 toxicity rates were 12% at 1 year.


CONCLUSIONS
This review shows relatively low toxicity for interstitial planar seed implantation after thoracic surgical resection. The high local control results suggest that an incomplete oncologic surgery plus a brachytherapy implant for treating advanced thoracic malignancy merit further investigation.
Mutyala
Subhakar
S
Department of Radiation Oncology, Montefiore Medical Center and Albert Einstein College of Medicine in 1625 Poplar St., Bronx, New York, 10461, USA. smutyala@montefiore.org
Stewart
Alexandra
A
Khan
Atif J
AJ
Cormack
Robert A
RA
O'Farrell
Desmond
D
Sugarbaker
David
D
Devlin
Phillip M
PM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002276:Carcinoid Tumor / Q000532:radiotherapy / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D007890:Leiomyosarcoma / Q000532:radiotherapy / Q000601:surgery; D008175:Lung Neoplasms / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D008482:Mediastinum / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D012509:Sarcoma / Q000532:radiotherapy / Q000601:surgery; D013899:Thoracic Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D013997:Time Factors; D055815:Young Adult
D007457:Iodine Radioisotopes