Iodine-125 brachytherapy treatment for newly diagnosed brain metastasis in non-small cell lung cancer: A biocentric analysis

Purpose The aim of the present study is to evaluate the safety and efficacy of iodine-125 brachytherapy for newly diagnosed brain metastasis in patients with non-small cell lung cancer (NSCLC). Materials and methods The study included 158 NSCLC patients diagnosed with brain metastasis from December 2003 to August 2017. Ninety-nine patients underwent external beam radiotherapy (EBRT group), and 59 patients received iodine-125 brachytherapy (125I group). In addition, the 6- and 12-month progression-free survival (PFS) rates and the 12- and 24-month overall survival (OS) rates were compared between the EBRT group and the 125I group. Median OS and PFS were analyzed using the Kaplan−Meier method with a log-rank test. Results The 6-month PFS rate was significantly higher in the 125I group (p = 0.002) than in the EBRT group, while no differences were found in the 12-month PFS rate (p = 0.184). Additionally, the 12- (p = 0.839) and 24-month (p = 0.284) OS rates were not significantly different between the two groups. No significant differences in median OS (p = 0.525) or PFS (p = 0.425) were found between the two groups. Conclusions Iodine-125 brachytherapy is an alternative therapy for patients unable to undergo surgical resection.

[1]  F. Heppner,et al.  Effectiveness of Immune Checkpoint Inhibition vs Chemotherapy in Combination With Radiation Therapy Among Patients With Non–Small Cell Lung Cancer and Brain Metastasis Undergoing Neurosurgical Resection , 2022, JAMA network open.

[2]  Wei Zhang,et al.  Clinical importance of ADC in the prediction of 125I in the treatment for gliomas , 2021, Journal of Cancer.

[3]  Haichen Zhang,et al.  Safety and efficacy of 3D-printed templates assisted CT-guided radioactive iodine-125 seed implantation for the treatment of recurrent cervical carcinoma after external beam radiotherapy , 2020, Journal of gynecologic oncology.

[4]  E. Yorke,et al.  Single- and Multifraction Stereotactic Radiosurgery Dose/Volume Tolerances of the Brain. , 2020, International journal of radiation oncology, biology, physics.

[5]  Ying Luan,et al.  Permanent iodine-125 brachytherapy for patients with progressive or recurrent high-grade gliomas , 2020, BMC Cancer.

[6]  M. Ludwig,et al.  Brachytherapy. , 2020, JAMA oncology.

[7]  C. Zheng,et al.  Transarterial chemoembolization combined with iodine 125 seeds versus transarterial chemoembolization combined with radiofrequency ablation in the treatment of early- and intermediate-stage hepatocellular carcinoma , 2020, BMC Gastroenterology.

[8]  G Vogin,et al.  Radionecrosis after stereotactic radiotherapy for brain metastases , 2016, Expert review of neurotherapeutics.

[9]  Hyun Soo Shin,et al.  Radical prostatectomy versus high dose permanent prostate brachytherapy using iodine-125 seeds for patients with high risk prostate cancer: a matched cohort analysis , 2013, World Journal of Urology.

[10]  C. Belka,et al.  Iodine-125 brachytherapy for brain tumours - a review , 2012, Radiation Oncology.

[11]  Jian Lu,et al.  CT-guided interstitial brachytherapy of inoperable non-small cell lung cancer. , 2011, Lung cancer.

[12]  S. Walsh Radiobiological modelling in Radiation Oncology , 2011 .

[13]  Y. Zou,et al.  Intraoperative radiofrequency ablation combined with 125 iodine seed implantation for unresectable pancreatic cancer. , 2010, World journal of gastroenterology.

[14]  Huishu Yuan,et al.  Percutaneous computed tomography/ultrasonography-guided permanent iodine-125 implantation as salvage therapy for recurrent squamous cell cancers of head and neck , 2010, Cancer biology & therapy.

[15]  K. Smedby,et al.  Brain metastases admissions in Sweden between 1987 and 2006 , 2009, British Journal of Cancer.

[16]  Hui-shu Yuan,et al.  Interstitial permanent implantation of 125I seeds as salvage therapy for re-recurrent rectal carcinoma , 2009, International Journal of Colorectal Disease.

[17]  Jill S Barnholtz-Sloan,et al.  Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  W R Markesbery,et al.  Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. , 1998, JAMA.

[19]  M. Higashiyama,et al.  Surgical treatment of brain metastases of lung cancer: retrospective analysis of 89 cases. , 1994, Journal of neurology, neurosurgery, and psychiatry.

[20]  A. Jemal,et al.  Cancer statistics, 2019 , 2019, CA: a cancer journal for clinicians.

[21]  N. Dubrawsky Cancer statistics , 1989, CA: a cancer journal for clinicians.

[22]  Eliseu Becco Neto Análise dimensional de metástases cerebrais de carcinoma de pulmão do tipo não-pequenas células para otimização da resposta terapêutica à radiocirurgia estereotáxica , 2022 .