Abstract
PurposeThis study sought to assess the safety and effect of 125I seed implantation for palliation of painful bone metastases from lung cancer after failure or rejection of conventional treatments.Materials and Methods89 patients with painful bone metastases secondary to lung cancer were consented and enrolled in this study from June 2013 to May 2015. All patients had failed or refused conventional treatments underwent percutaneous CT-guided 125I seed implantation. The Brief Pain Inventory (BPI) was used to measure pain intensity prior to treatment (T0), 2, 4, 6, 8 and 12 weeks (T2, T4, T6, T8 and T12) after treatment in a 24-hour period. Analgesic, quality of life (QOL) scores and complications were also recorded. Four patients were excluded as they were lost to follow-up or had incomplete data.Results85 patients with 126 bone metastases from lung cancer were treated. There were significantly lower scores after treatment in the visual analog scale (VAS) and analgesic. The VAS scores for worst pain was 6.3±1.8 at T0. At T2, T4, T6, T8 and T12, the score in a 24-hour period decreased to 4.9±1.2 (P<0.01), 3.7±1.3 (P<0.01), 3.4±1.2 (P<0.01), 2.6±0.9 (P<0.01), and 1.4±0.8 (P<0.01) respectively. Comparison of QOL scores showed improvements including sleep, appetite, spiritual state, and fatigue at T2, T4, T6, T8 and T12 when compared to T0. No serious complications or massive bleeding were observed.Conclusions125I brachytherapy is a safe and effective method for palliation of painful bone metastases from lung cancer after failure or rejection of conventional treatments.
Highlights
Bone was a common site of metastasis for patients with lung cancer, non-small cell lung cancer, approximately 30-40% would appear skeletal metastases [1]
Conventional treatments were defined as bone metastases secondary to lung cancer had received local control therapies (external beam radiation therapy (EBRT), chemotherapy, analgesics and so on) before 125I brachytherapy [4]
Palliative therapy was seen as the standard of care for painful bone metastases from lung cancer, previous studies suggested that traditional therapies had achieved a certain effect [5, 6]
Summary
Bone was a common site of metastasis for patients with lung cancer, non-small cell lung cancer, approximately 30-40% would appear skeletal metastases [1]. Pain was the most common clinical symptom of bone metastases and seriously decreased the QOL of tumor patients [2]. More than half of lung cancer patients with painful bone metastases were difficult to obtain clinical remission during the treatment [3]. Conventional treatments were defined as bone metastases secondary to lung cancer had received local control therapies (external beam radiation therapy (EBRT), chemotherapy, analgesics and so on) before 125I brachytherapy [4]. Chemotherapy and EBRT remained the most www.impactjournals.com/oncotarget common methods, EBRT was been reported to achieve remission in 60% of patients [7]. Treatment options include hormone therapy, radiopharmaceuticals, bisphosphonates, and analgesic agents
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