Computed tomography fluoroscopy‑guided percutaneous 125I seed implantation for safe, effective and real‑time monitoring radiotherapy of inoperable stage T1‑3N0M0 non‑small‑cell lung cancer

Li,Jiakai; Yu,Miao; Xiao,Yueyong; Yang,Li; Zhang,Jinshan; Ray,Erik; Yang,Xiaoming

doi:10.3892/mco.2013.171

Computed tomography fluoroscopy‑guided percutaneous 125I seed implantation for safe, effective and real‑time monitoring radiotherapy of inoperable stage T1‑3N0M0 non‑small‑cell lung cancer

Authors:
- Jiakai Li
- Miao Yu
- Yueyong Xiao
- Li Yang
- Jinshan Zhang
- Erik Ray
- Xiaoming Yang
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Affiliations: Department of Radiology, Chinese PLA General Hospital, Beijing 100853, P.R. China, Image‑Guided Bio‑Molecular Interventions Research and Division of Vascular and Interventional Radiology, Department of Radiology, University of Washington School of Medicine, Seattle, WA 98109, USA
Published online on: August 23, 2013 https://doi.org/10.3892/mco.2013.171
Pages: 1019-1024

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Abstract

The management of inoperable lung cancer remains a challenge. It has been proven that computed tomography (CT)‑guided iodine‑125 (125I) seed implantation is a safe and efficient method for treating lung cancer. computed tomographic fluoroscopy (CTF) is superior to traditional CT for percutaneous management of lung lesions, due to the real‑time guidance and accurate localization of the lesions. The aim of the present prospective study was to evaluate the feasibility, safety and efficacy of CTF‑guided percutaneous permanent implantation of 125I seeds for the treatment of selected patients with inoperable stage T1‑3N0M0 non‑small‑cell lung cancer (NSCLC). A total of 24 patients with resectable but inoperable stage T1‑3N0 NSCLC, with a total of 28 lesions, underwent CTF‑guided percutaneous implantation of radioactive 125I seeds. A prescription dose of 100‑120 Gy was delivered to each lesion. The complications and local tumor control rates were documented. Survival was estimated using the Kaplan‑Meier method. All the patients successfully completed the procedure, with a mean procedure duration of 45.7 min (range, 30‑75 min). No severe complications occurred. Small asymptomatic pneumothorax with lung volume compression of <10% and minor hemorrhage along the needle track without hemoptysis occurred immediately after the procedure in 3 (12.5%) and 4 (16.7%) of the 24 patients, respectively. At a median follow‑up of 31.5 months (range, 8‑46 months), the local control rate (LCR) of the lesions was 78.6% (22/28). The 1‑, 2‑ and 3‑year overall survival rate was 95.8, 78 and 55%, respectively. In conclusion, CTF is the favourable imaging guidance method for the percutaneous implantation of 125I seeds. CTF‑guided brachytherapy with implantation of 125I seeds is a safe, feasible and effective modality for the treatment of inoperable early‑stage NSCLC and may be considered an alternative option in selected patients with medically inoperable NSCLC.

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