Clinical Observation Of Different Dose Of ¹²⁵I Seed In The Treatment For Non-small Cell Lung Cancer

Objective:Currently,¹²⁵I seed has been used for non-small cell lung cancer（NSCLC）,and has achieved better local tumor control.However,the focus of recent research has been on the clinical efficacy of ¹²⁵I seed in the treatment of non-small cell lung cancer.The dose determines the efficacy and complications,the dose of different departments have been very different,and the efficacy and complications have been not the same.However,the most suitable dose have not been standardized by any guideline or randomized prospective trial,so further study is needed.In this study,we evaluated the efficacy,complications and symptom that received different dose to give advanced on the ¹²⁵I seed implantation treatment for non-small cell lung cancer.Methods:We reviewed 58 non-small cell lung cancer from March 2013to September 2017,with 58 lesions.All patients received ¹²⁵I seed implantation and the clinical data were complete.All patients were divided into three groups according to D90（the minimum dose accepted by 90%of the target volume）after operation.19 patients received 80Gy-99Gy（group A）,20 patients received 100Gy-119Gy（group B）,19 patients received 120Gy-140Gy（group C）.The efficacy,complications and symptom were observed 3months after operation.Results:The local control rate in the three groups of A,B and C was84.2%,85.0%and 100.0%,respectively,and the effective rate was 26.3%,40.0%and 57.9%,respectively.The improvement rate of cough symptom among three groups was 26.3%,40.0%and 52.5%after the ¹²⁵I seed implantation,respectively.The improvement rate of chest tightness was21.1%,35.0%and 47.4%respectively.16 patients had pneumothorax in the operation,and 4 patients were treated with closed thoracic drainage.The remaining 12 patients had no treatment because the pneumothorax was less than 20%of unilateral lung volume.10 patients had bleed,and one developed into hemothorax,received closed thoracic drainage and hemostatic drugs.3days later,the drainage tube was removed after the chest CT confirmed no active bleeding.9 cases of blood loss about 20 ml or less,only received hemostatic drugs.Seeds migration were observed in 5 patient during the follow-up.No radiation pneumonia,air embolism,or surgical death occurred in all patients.Conclusions:1.¹²⁵I seed implantation for non-small cell lung cancer is safe and effective.2.¹²⁵I seed implantation can improve the symptom of patients with non-small cell lung cancer.3.The prescription dose was higher than 120Gy,which may achieve better short-term efficacy in ¹²⁵I seed implantation for non-small cell lung cancer.