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

PURPOSE: To retrospectively evaluate the effectiveness and safety of CT-guided I-125 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. (C) 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.