Xiaodong Huo1, Huixing Wang2, Jingkui Yang1, Xiaodong Li3, Weiliang Yan1, Bin Huo4, Guangjun Zheng1, Shude Chai1, Junjie Wang5, Zhiyu Guan6, Zhengtao Yu7. 1. Department of Thoracic Surgery, Second Hospital of Tianjin Medical University, Tianjin, R. P. China. 2. Department of Pain Treatment, Pain Management Center, Second Hospital of Tianjin Medical University, Tianjin, R. P. China. 3. Department of Radiology, Second Hospital of Tianjin Medical University, Tianjin, R. P. China. 4. Department of Oncology, Coastal People's Hospital of Tianjin, Tianjin, R. P. China. 5. Department of Radiation Oncology, Third Hospital Peking University, Beijing, R. P. China. 6. Department of Thoracic Surgery, Second Hospital of Tianjin Medical University, Tianjin, R. P. China. Electronic address: hxd_204@163.com. 7. Department of Esophageal Oncology, Key Laboratory of Cancer Prevention and Therapy, Cancer Institute and Hospital of Tianjin Medical University, Tianjin, R. P. China. Electronic address: yuzhtao@hotmail.com.
Abstract
PURPOSE: To retrospectively evaluate the effectiveness and safety of CT-guided (125)I seed brachytherapy (CTISB) in 38 non-small cell lung cancer (NSCLC) patients with locoregional recurrence (LRR). METHODS AND MATERIALS: In total, we analyzed 38 NSCLC patients with LRR treated with percutaneous CTISB in our hospital between 2001 and 2008; among them, 15 also received combined chemotherapy: 1-6 cycles (median, 2) of platinum-based regimens. The change in tumor volume was evaluated based on followup contrast material-enhanced CT or positron emission tomography scans. RESULTS: The median Day 0 dosimetry was as follows: The volume treated with the prescription dose (V100) was 96.3% (90.1-123.5%), and the minimum dose received by at least 90% of the tumor volume (D90) was 124.8 Gy (116.0-130.7 Gy). The median duration of the followup period calculated from the first CTISB treatment was 22.5 months (range, 8-98 months). Two months after CTISB, complete response, partial response, and progressive disease were observed in 50%, 37%, and 8% of patients, respectively. Median overall survival (OS) after CTISB was 21 months (95% confidence interval, 7.4-34.6), and the rates of 2-year OS, progression-free survival, and local control were 47.4%, 39.5%, and 83.5%, respectively. Both univariate and multivariate analysis indicated that D90 was significant prognostic factors for OS and progression-free survival. CONCLUSION: For selected NSCLC patients with limited LRR, CTISB is effective and can provide a high rate of local cancer control with minimal trauma.
PURPOSE: To retrospectively evaluate the effectiveness and safety of CT-guided (125)I seed brachytherapy (CTISB) in 38 non-small cell lung cancer (NSCLC) patients with locoregional recurrence (LRR). METHODS AND MATERIALS: In total, we analyzed 38 NSCLCpatients with LRR treated with percutaneous CTISB in our hospital between 2001 and 2008; among them, 15 also received combined chemotherapy: 1-6 cycles (median, 2) of platinum-based regimens. The change in tumor volume was evaluated based on followup contrast material-enhanced CT or positron emission tomography scans. RESULTS: The median Day 0 dosimetry was as follows: The volume treated with the prescription dose (V100) was 96.3% (90.1-123.5%), and the minimum dose received by at least 90% of the tumor volume (D90) was 124.8 Gy (116.0-130.7 Gy). The median duration of the followup period calculated from the first CTISB treatment was 22.5 months (range, 8-98 months). Two months after CTISB, complete response, partial response, and progressive disease were observed in 50%, 37%, and 8% of patients, respectively. Median overall survival (OS) after CTISB was 21 months (95% confidence interval, 7.4-34.6), and the rates of 2-year OS, progression-free survival, and local control were 47.4%, 39.5%, and 83.5%, respectively. Both univariate and multivariate analysis indicated that D90 was significant prognostic factors for OS and progression-free survival. CONCLUSION: For selected NSCLCpatients with limited LRR, CTISB is effective and can provide a high rate of local cancer control with minimal trauma.