CT-guided implantation of radioactive 125I seed in advanced non-small-cell lung cancer after failure of first-line chemotherapy.
OBJECTIVE
We investigated implanting computed tomography (CT)-guided (125)I seed to treat locally advanced non-small-cell lung cancer (NSCLC) after chemotherapy failure.


METHODS
From January 2005 to July 2010, we recruited 69 patients with locally advanced NSCLC who had each had first-line chemotherapy four to six times but had progressive disease; 34 received (125)I seed implantation with second-line chemotherapy (Group A) and 35 received second-line chemotherapy only (Group B).


RESULTS
Mean follow-up was 32 months (range 5-56 months). Overall 2-year local control rate for existing lung lesions was Group A: 39.9 %; Group B: 12.5 % (P < 0.05). The 1-, 3-year, and median overall survival was 68.7 and 20.8 % at 17.4 months in Group A; and 45.1 and 18.7 % at 11.3 months in Group B, respectively (P > 0.05). Local 3-, 24-month, and median progression-free survival was Group A: 100 and 79.1 % at 11 months; Group B: 76.5 and 18.7 % at 7.3 months, respectively. The groups did not significantly differ in treatment toxicity. Chest pain remission was Group A: 82.1 % (23/28); Group B: 30.8 % (8/26) (P < 0.05). Group A showed no radiation-related pneumonia, esophagitis, bronchial fistulae, or life-threatening morbidity.


CONCLUSIONS
CT-guided radioactive seed (125)I implantation procedure is safe and well tolerated in treating locally advanced NSCLC, with few complications. It has good local control rate and can relieve symptoms without increasing side effects.
Department of Medical Imaging and Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, 651 Dongfeng Road, East, Guangzhou, 510060, People's Republic of China, zhangtao@sysucc.org.cn.
Tao
T
Zhang
Mingjian
M
Lu
Sheng
S
Peng
Weidong
W
Zhang
Guang
G
Yang
Zhenyin
Z
Liu
Sristi
S
Singh
Yadi
Y
Yang
Fujun
F
Zhang
Fei
F
Gao
D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage*; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals