CT-guided implantation of radioactive ^sup 125^I seed in advanced non-small-cell lung cancer after failure of first-line chemotherapy

We investigated implanting computed tomography (CT)-guided ^sup 125^I seed to treat locally advanced non-small-cell lung cancer (NSCLC) after chemotherapy failure. 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 ^sup 125^I seed implantation with second-line chemotherapy (Group A) and 35 received second-line chemotherapy only (Group B). 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. CT-guided radioactive seed ^sup 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.[PUBLICATION ABSTRACT]