Computed tomography fluoroscopy-guided percutaneous I-125 seed implantation for safe, effective and real-time monitoring radiotherapy of inoperable stage T1-3N0M0 non-small-cell lung cancer

被引：21

作者：

Li, Jiakai ^{[1
,2
,3
]}

Yu, Miao ^{[1
]}

Xiao, Yueyong ^{[1
]}

Yang, Li ^{[1
]}

Zhang, Jinshan ^{[1
]}

Ray, Erik ^{[2
,3
]}

Yang, Xiaoming ^{[2
,3
]}

机构：

[1] Chinese Peoples Liberat Army Gen Hosp, Dept Radiol, 28 Fuxing Rd, Beijing 100853, Peoples R China

[2] Univ Washington, Sch Med, Dept Radiol, Image Guided Biomol Intervent Res, Seattle, WA 98109 USA

[3] Univ Washington, Sch Med, Dept Radiol, Div Vasc & Intervent Radiol, Seattle, WA 98109 USA

来源：

MOLECULAR AND CLINICAL ONCOLOGY | 2013年 / 1卷 / 06期

关键词：

non-small-cell lung cancer; iodine-125; seed; brachytherapy; computed tomography fluoroscopy; image guidance;

D O I：

10.3892/mco.2013.171

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The management of inoperable lung cancer remains a challenge. It has been proven that computed tomography (CT) -guided iodine-125 (I-125) seed implantation is a safe and efficient method for treating lung cancer. Computed tomographic fluoroscopy (CTF) is superior to traditional CT for percutaneous management of lung lesions, due to the real-time guidance and accurate localization of the lesions. The aim of the present prospective study was to evaluate the feasibility, safety and efficacy of CTF-guided percutaneous permanent implantation of I-125 seeds for the treatment of selected patients with inoperable stage T1-3N0M0 non-small-cell lung cancer (NSCLC). A total of 24 patients with resectable but inoperable stage T1-3N0 NSCLC, with a total of 28 lesions, underwent CTF-guided percutaneous implantation of radioactive I-125 seeds. A prescription dose of 100-120 Gy was delivered to each lesion. The complications and local tumor control rates were documented. Survival was estimated using the Kaplan-Meier method. All the patients successfully completed the procedure, with a mean procedure duration of 45.7 min (range, 30-75 min). No severe complications occurred. Small asymptomatic pneumothorax with lung volume compression of < 10% and minor hemorrhage along the needle track without hemoptysis occurred immediately after the procedure in 3 (12.5%) and 4 (16.7%) of the 24 patients, respectively. At a median follow-up of 31.5 months (range, 8-46 months), the local control rate (LCR) of the lesions was 78.6% (22/28). The 1-, 2- and 3-year overall survival rate was 95.8, 78 and 55%, respectively. In conclusion, CTF is the favourable imaging guidance method for the percutaneous implantation of I-125 seeds. CTF-guided brachytherapy with implantation of I-125 seeds is a safe, feasible and effective modality for the treatment of inoperable early-stage NSCLC and may be considered an alternative option in selected patients with medically inoperable NSCLC.

引用

页码：1019 / 1024

页数：6