¹²⁵I brachytherapy of locally advanced non-small-cell lung cancer after one cycle of first-line chemotherapy: a comparison with best supportive care

Figures & data

Figure 1 A 58-year-old male patient with adenocarcinoma located in the middle lobe of the right lung next to heart.

Notes: (A) Dose distribution on TPS 1 week after one cycle of the first-line chemotherapy. (B) Dose distribution after CT-guided percutaneous ¹²⁵I seed implantation.
Abbreviations: TPS, treatment planning system; CT, computed tomography.

Table 1 Demographic characteristics of patients in the study

Characteristics	Group A (n=16)	Group B (n=16)	P-value
Age, mean (SD)	56.6 (12.0)	58.3 (10.7)	0.80
Gender (male:female)	12:4	10:6	0.45
Histology
SCC	5	5	>0.99
AC	7	7	>0.99
LCC	4	4	>0.99
UICC TNM classification
Stage IIIA	7 (43.8)	7 (43.8)	>0.99
Stage IIIB	9 (56.2)	9 (56.2)	>0.99
Tumor location
The central type	5	5	>0.99
The peripheral type	11	11	>0.99
Lesion diameter
≤3 cm	6	6	>0.99
3–5 cm	10	10	>0.99
Concomitant illness
COPD	3	3	>0.99
Diabetes	5	5	>0.99
Hypertension	8	8	>0.99
Performance status
0	2	2	>0.99
1	3	3	>0.99
2	11	11	>0.99

Abbreviations: SD, standard deviations; SCC, squamous cell carcinoma; AC, adenocarcinoma; LCC, large cell carcinoma; UICC TNM, union for international cancer control tumor node metastasis; COPD, chronic obstructive pulmonary emphysema.

Figure 2 Kaplan–Meier survival analysis and log-rank test compared the progression-free survival time between patients in groups A and B (median progression-free survival time, χ²=36.1, P<0.001, log-rank test).

Abbreviation: Cum, cumulative.

Figure 3 Kaplan–Meier survival analysis and log-rank test compared the overall survival time between patients in groups A and B (median overall survival time here, χ²=6.114, P=0.013, log-rank test).

Abbreviation: Cum, cumulative.

Table 2 Clinical efficacy of ¹²⁵I brachytherapy in locally advanced NSCLC

Group	Local control efficacy (%)				RR = CR + PR (%)
	CR	PR	SD	PD	(P<0.01)
A	7 (43.8%)	5 (31.3%)	1 (6.25%)	3 (18.8%)	12 (75.0%)
B	0 (0.0%)	0 (0.0%)	3 (43.8%)	13 (81.3%)	0 (0.0%)

Abbreviations: NSCLC, non-small-cell lung cancer; RR, response rate; CR, complete responses; PR, partial responses; PD, progressive disease; SD, stable disease.

Table 3 Relief of symptoms associated with the tumor in both groups

Symptoms	Group A				Group B				P-value
	SR	PR	NR	AG	SR	PR	NR	AG
Cough	7/14	4/14	2/14	1/14	0/15	0/15	5/15	10/15	<0.01
Chest pain	5/9	2/9	1/9	1/9	0/12	0/12	4/12	8/12	<0.01
Bloody sputum	6/12	3/12	2/12	1/12	0/16	0/16	3/16	13/16	<0.01
Hoarseness	2/8	4/8	1/8	1/8	0/7	0/7	4/7	3/7	<0.01
Chest tightness	3/11	5/11	1/11	2/11	0/10	0/10	6/10	4/10	<0.01

Abbreviations: SR, significant remission; PR, partial responses; NR, no remission; AG, aggravation.

Figure 4 A 69-year-old male patient with adenocarcinoma of the right lower lobe who underwent ¹²⁵I permanent brachytherapy 2 weeks after one cycle of the first-line chemotherapy.

Notes: (A) PET-CT scan before treatment. (B–D) PET-CT imaging follow-up 1, 3, and 6 months after ¹²⁵I permanent brachytherapy, the treatment induced significant shrinkage of tumor size due to the tumor necrosis in the center of tumor (CR). The particles remained in the tumor without any migration into the lung.
Abbreviations: PET-CT, positron emission tomography-computed tomography; CR, complete response.