CT-Guided 125i Seed Implantation for In-Field Recurrence of NSCLC With Prior Radiation

Abstract

PurposeTo assess the feasibility, efficacy, and morbidity of CT image-guided radioactive iodine 125 (125I) seed implantation for in-field recurrence of NSCLC with prior radiation.Materials and Methods14 patients received CT-guided percutaneous permanent implantation of 125I seeds for in-field recurrence of NSCLC between October 2010 and August 2014. All patients received radiotherapy before seed implantation. The tumor volumes were measured using CT scans at 5-mm intervals one week before seed implantation. Postoperative dosimetry was routinely performed for all patients. The D90 (the doses delivered to 90% of the target volume defined by CT using dose-volume histogram) of the implanted 125I seeds ranged from 83Gy to 224Gy (median: 111 Gy). The activity of 125I seeds ranged from 0.58mCi to 0.75mCi (median: 0.72mCi). The total number of seeds implanted ranged from 16 to 61 (median: 39). The survival and local control probabilities were calculated by the Kaplan-Meier method.ResultsThe median local control was 7months (95% CI, 4.26-9.74 months). The 1- and 2-year local control rates were 33.3%, and 33.3%, respectively. The estimate median overall survival is 18 months (95% CI, 11.91-24.09 months). The 1- and 2-year overall survival rates were 67.5%, 27.0% respectively. 71.4% of the symptoms (10/14) had disappeared or improved. No patients had radiation pneumonia, or radiation esophagitis in follow-up. One patient developed lethal hemoptysis 18 months after seed implantation.ConclusionsInterstitial permanent implantation of 125-I seeds under CT guidance is feasible, efficacy and safe method for in-field recurrence of NSCLC with prior radiation. PurposeTo assess the feasibility, efficacy, and morbidity of CT image-guided radioactive iodine 125 (125I) seed implantation for in-field recurrence of NSCLC with prior radiation. To assess the feasibility, efficacy, and morbidity of CT image-guided radioactive iodine 125 (125I) seed implantation for in-field recurrence of NSCLC with prior radiation. Materials and Methods14 patients received CT-guided percutaneous permanent implantation of 125I seeds for in-field recurrence of NSCLC between October 2010 and August 2014. All patients received radiotherapy before seed implantation. The tumor volumes were measured using CT scans at 5-mm intervals one week before seed implantation. Postoperative dosimetry was routinely performed for all patients. The D90 (the doses delivered to 90% of the target volume defined by CT using dose-volume histogram) of the implanted 125I seeds ranged from 83Gy to 224Gy (median: 111 Gy). The activity of 125I seeds ranged from 0.58mCi to 0.75mCi (median: 0.72mCi). The total number of seeds implanted ranged from 16 to 61 (median: 39). The survival and local control probabilities were calculated by the Kaplan-Meier method. 14 patients received CT-guided percutaneous permanent implantation of 125I seeds for in-field recurrence of NSCLC between October 2010 and August 2014. All patients received radiotherapy before seed implantation. The tumor volumes were measured using CT scans at 5-mm intervals one week before seed implantation. Postoperative dosimetry was routinely performed for all patients. The D90 (the doses delivered to 90% of the target volume defined by CT using dose-volume histogram) of the implanted 125I seeds ranged from 83Gy to 224Gy (median: 111 Gy). The activity of 125I seeds ranged from 0.58mCi to 0.75mCi (median: 0.72mCi). The total number of seeds implanted ranged from 16 to 61 (median: 39). The survival and local control probabilities were calculated by the Kaplan-Meier method. ResultsThe median local control was 7months (95% CI, 4.26-9.74 months). The 1- and 2-year local control rates were 33.3%, and 33.3%, respectively. The estimate median overall survival is 18 months (95% CI, 11.91-24.09 months). The 1- and 2-year overall survival rates were 67.5%, 27.0% respectively. 71.4% of the symptoms (10/14) had disappeared or improved. No patients had radiation pneumonia, or radiation esophagitis in follow-up. One patient developed lethal hemoptysis 18 months after seed implantation. The median local control was 7months (95% CI, 4.26-9.74 months). The 1- and 2-year local control rates were 33.3%, and 33.3%, respectively. The estimate median overall survival is 18 months (95% CI, 11.91-24.09 months). The 1- and 2-year overall survival rates were 67.5%, 27.0% respectively. 71.4% of the symptoms (10/14) had disappeared or improved. No patients had radiation pneumonia, or radiation esophagitis in follow-up. One patient developed lethal hemoptysis 18 months after seed implantation. ConclusionsInterstitial permanent implantation of 125-I seeds under CT guidance is feasible, efficacy and safe method for in-field recurrence of NSCLC with prior radiation. Interstitial permanent implantation of 125-I seeds under CT guidance is feasible, efficacy and safe method for in-field recurrence of NSCLC with prior radiation.