The Clinical Value of Computed Tomography (CT)-Guided ¹²⁵I Brachytherapy for Locally Advanced Non-Small Cell Lung Cancer After Progression of Concurrent Radiochemotherapy

Abstract

Purpose

To further evaluate the efficacy and safety of computed tomography (CT)-guided iodine 125 (¹²⁵I) brachytherapy to treat locally advanced non-small cell lung cancer (NSCLC) after progression of concurrent radiochemotherapy (CCRT).

Methods

This study obtained written consent from all patients and was approved by our institution. From January 2006 to June 2018, 210 NSCLC patients (progression of first-line CCRT) were retrospectively recruited and then divided into two groups. A total of 116 patients were given CT-guided ¹²⁵I brachytherapy and second-line chemotherapy (group A), and 94 were treated with second-line chemotherapy alone (group B).

Results

In group A, local response rate (LRR) within 3 years was significantly better (P<0.05). Mean survival time [progression-free survival time (PFST) and overall survival (OS)] was 15.1±1.4 months and 21.2±1.6 months in group A compared with 10.0±1.4 months and 16.2±1.7 months in group B (PFST: P<0.01, HR=1.472, 95% CI 1.097–1.975; OS: P = 0.036, HR=1.342, 95% CI 1.005–1.791). Tumor size and No. of first cycle chemotherapy were independent factors that affected survival, ≤3cm largest tumor diameter and more than 4 first cycles of chemotherapy showed longer PFST and OS (P<0.05). Tumor-related clinical symptoms were relieved in group A (P<0.01). No serious complications occurred in the two groups.

Conclusion

¹²⁵I brachytherapy is effective and safe in locally advanced NSCLC after progression of CCRT.

Keywords:

• ¹²⁵I
• brachytherapy
• NSCLC
• concurrent radiochemotherapy
• efficacy
• safety

Abbreviations

CT, computed tomography; NSCLC, non-small cell lung cancer; CCRT, concurrent radiochemotherapy; LRR, local response rate; PFST, progression-free survival time; OS, overall survival; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease.

Ethics and Consent Statement

This study protocol was approved by the institutional review board of the Third affiliated hospital of Sun Yat-sen University. The study was conducted in accordance with the ethical principles laid down in the Declaration of Helsinki. Written informed consent was obtained from all patients before treatment.

Disclosure

The authors declare that there are no conflicts of interest.