Factors Influencing The Short-term Efficacy Of ¹²⁵I Seed Implantation In Local Advanced Non-small Cell Lung Cancer

Objective:Analyze CT-guided radioactive ¹²⁵I particle implantation treatment for locally advanced non-small cell lung cancer（Non-small cell lung cancer,NSCLC）recent curative effect of related factors of monitoring adverse reactions occurred after particles implantation at the same time,in the hope of radioactive ¹²⁵I particle implantation for locally advanced NSCLC patients clinical diagnosis and treatment work to provide the reference and prognosis evaluation.Methods:The clinical data of 42 patients with advanced NSCLC who received CT-guided intertissue implantation of radioactive ¹²⁵I seeds and met the inclusion criteria from May 2015 to February 2019 in our center were systematically reviewed,and the risk factors that might affect the short-term efficacy of seed implantation were extracted from them.At the same time,according to the chest CT scan results of patients 6 months after surgery,Response Evaluation Criteria In Solid Tumors（RECIST 1.1）Solid tumor Evaluation Criteria were used,and the efficacy was evaluated according to the change of tumor size 6 months after surgery.Statistical software（SPSS 24.0）was used to analyze the related factors affecting the short-term efficacy of particle implantation for NSCLC.The clinical factors including gender,age,pathological type,combination chemotherapy,surgical method,activity,dose,smoking,PS score and the curative effect 6 months after ¹²⁵I radioactive seed implantation were selected for univariate analysis,and the screened influencing factors were included in Logistic regression model for multivariate analysis.Results:All the patients underwent CT-guided radioactive ¹²⁵I intertissue-seed implantation.Six months after surgery,all 42 patients survived,and the short-term efficacy was good,with a tumor control rate of83%and an effective rate of 45%.In addition,there were few adverse reactions,including 15 cases of pneumothorax,5 cases of hemorrhage,2 cases of particle displacement,and no serious complications such as radiation pneumonia.ROC curve analysis was performed on the longest diameter of tumor and postoperative D90,and the optimal threshold was 4.5cm,120Gy.According to univariate analysis results,the short-term response rate（CR+PR）was significantly different under the three factors of gender（female）,longest tumor diameter（<4.5cm）and postoperative D90（≥120Gy）（P<0.05）.These factors were put into the Logistic regression model for multivariate analysis,and the results showed that postoperative D90≥120Gy was an independent influencing factor for the short-term efficacy of radioactive seed implantation therapy for middle and advanced NSCLC.Conclusions:1.CT-guided radioactive ¹²⁵I intertissue-seed implantation can be achieved in the treatment of advanced NSCLC.It is a minimally invasive treatment technique of great clinical value with better local control and less adverse reactions2.According to the results of multivariate analysis in this study,D90≥120Gy was an independent influencing factor for ¹²⁵I radioactive seed implantation.