Implantation of ~(125)I Seeds Combined with Radiotherapy and/or Chemotherapy for Local Recurrent Lung Cancer at a Late Stage / 中国微创外科杂志

ABSTRACT

Objective To explore the efficacy of implantation of 125I seeds combined with radiotherapy and/or chemotherapy for local recurrent lung cancer at a late stage.Methods A total of thirty-two patients were received implantation of 125I seeds therapy with a MPD of 110 to 140 Gy in our hospital.CT scan was used for guidance.Before the operation,a therapeutic plan was made by TPS.The therapeutic target volume(PTV)included the clinical target volume(CTV)plus the surrounding tissues 1 cm adjacent to the edge of CTV.The activity of each seeds was set at 0.7 mCi.The distribution of the seeds was checked by CT scan immediately after the implantation.Then,chemotherapy or radiotherapy was carried out in 3 to 7 days.EP,NP,or TP was used for the patients receiving chemotherapy.Results In 2 to 4 months after the treatments,the CR,PR,and NC were 46.9%(15/32),37.5%(12/32),and 15.6%(5/32),respectively.The rate of complete local control was 84.4%(CR+PR).The 1-and 2-year survival rate in this series were 78.6%(22/28)and 66.7%(10/15).Four of these patients survived over 3 years.Eleven of the patients(34.4%)developed pneumothorax after the implantation,3 of them were cured by chest drainage;9 patients(28.1%)had hemorrhage including 5 cases of intrapulmonary bleeding and 4 cases of emptysis.In 3 cases(9.4%),the seeds missed the target,and dropped into the diaphragmatic muscle at the thoracic cavity(2 cases)or out of the target area(1 case).No seeds migration or radiation-induced lung injury was found.Conclusion Implantation of 125I seeds combined with radiotherapy and/or chemotherapy is effective for patients with local recurrent lung cancer at a late stage.