title: The combined treatment of CT-guided percutaneous 125I seed implantation and chemotherapy for non-small-cell lung cancer.
abstract: OBJECTIVE
  Gemcitabine plus cisplatin (GP) is a first-line treatment for advanced non-small-cell lung cancer (NSCLC). In this study, we evaluated the efficacy and safety of a combined treatment consisting of CT-guided percutaneous (125)I seed implantation with GP chemotherapy for advanced NSCLC.
  
  
  METHODS
  Fifty-three patients with advanced NSCLC were enrolled in a nonrandomized, two-armed clinical trial. Of these patients, 24 received a combination treatment of CT-guided percutaneous (125) I seed implantation and GP (the combo group), while 29 were treated with GP only (the control group).
  
  
  RESULTS
  Patients in the combo group received (125)I seed implantation with prescription dose of 100-140 Gy and a total of 55 cycles of GP, and patients in the control group received a total of 73 cycles of GP. The overall response rate was 79.2% in the combo group and 41.4% in the control group. The median overall survival time was 13.5 ± 1.5 months in the combo group and 9.0 ± 1.8 months in the control group. The progression-free survival time was 8.0 ± 1.2 months in the combo group and 5.0 ± 0.8 months in the control group. The 1- and 2-year survival rates were 62.5 and 16.7% in the combo group, respectively, and 41.4 and 13.8% in the control group. The interventional complications in the combo group included 5 cases of pneumothorax and 4 cases of hemoptysis. There were no complications due to radiation pneumonia or radiation esophagitis in the combo group, and no patients had lethal hemoptysis or esophagotracheal fistula. Chemotherapy treatment-related toxicities, including Grade 3/4 myelosuppression and Grade 3 gastrointestinal toxicity, were similar in both groups.
  
  
  CONCLUSIONS
  Our initial experience showed that combined CT-guided (125)I radioactive seed implantation and GP chemotherapy are effective and safe for treating advanced NCSLC.
authors.affiliation: Department of General Surgery, The First Affiliated Hospital, Wenzhou Medical College, Wenzhou, 325000, China.
authors.forename: Shengchu
authors.initials: S
authors.lastname: Zhang
authors.forename: Yihu
authors.initials: Y
authors.lastname: Zheng
authors.forename: Panpan
authors.initials: P
authors.lastname: Yu
authors.forename: Fuxiang
authors.initials: F
authors.lastname: Yu
authors.forename: Qiyu
authors.initials: Q
authors.lastname: Zhang
authors.forename: Yinxiang
authors.initials: Y
authors.lastname: Lv
authors.forename: Xiaoxi
authors.initials: X
authors.lastname: Xie
authors.forename: Yunxiao
authors.initials: Y
authors.lastname: Gao
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001918:Brachytherapy / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided; D014057:Tomography, X-Ray Computed / Q000379:methods*; D000093542:Gemcitabine
chemical_list: D007457:Iodine Radioisotopes; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine