Effectiveness and safety of CT-guided 125I seed brachytherapy for postoperative locoregional recurrence in patients with non–small cell lung cancer

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 ( V 100 ) was 96.3% (90.1–123.5%), and the minimum dose received by at least 90% of the tumor volume ( D 90 ) 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 D 90 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.