The Clinical Value of Computed Tomography (CT)-Guided 125I Brachytherapy for Locally Advanced Non-Small Cell Lung Cancer After Progression of Concurrent Radiochemotherapy

Purpose: To further evaluate the efficacy and safety of computed tomography (CT)-guided iodine 125 ( 125 I) brachytherapy to treat locally advanced non-small cell lung cancer (NSCLC) after progression of concurrent radiochemotherapy (CCRT). Methods: This study obtained written consent from all patients and was approved by our institution. From January 2006 to June 2018, 210 NSCLC patients (progression of first-line CCRT) were retrospectively recruited and then divided into two groups. A total of 116 patients were given CT-guided 125 I brachytherapy and second-line chemotherapy (group A), and 94 were treated with second-line chemotherapy alone (group B). Results: In group A, local response rate (LRR) within 3 years was significantly better (P< 0.05). Mean survival time [progression-free survival time (PFST) and overall survival (OS)] was 15.1± 1.4 months and 21.2± 1.6 months in group A compared with 10.0± 1.4 months and 16.2± 1.7 months in group B (PFST: P< 0.01, HR=1.472, 95% CI 1.097– 1.975; OS: P = 0.036, HR=1.342, 95% CI 1.005– 1.791). Tumor size and No. of first cycle chemotherapy were independent factors that affected survival, ≤ 3cm largest tumor diameter and more than 4 first cycles of chemotherapy showed longer PFST and OS (P< 0.05). Tumor-related clinical symptoms were relieved in group A (P< 0.01). No serious complications occurred in the two groups. Conclusion: 125 I brachytherapy is effective and safe in locally advanced NSCLC after progression of CCRT.