Efficacy And Safety Of Iodine-125 Radioactive Seeds Brachytherapy For Advanced Non-small Cell Lung Cancer-A Meta-analysis

Objective:In the world,advanced non-small cell lung cancer（NSCLC）,with a high fatality rate,is currently showing a trend of multiple.Different guidelines provide various suggestions on the treatment of NSCLC.In this study,the effectiveness and safety of ¹²⁵I seed implantation in the treatment of NSCLC were discussed and deficiencies and existing problems were analyzed by collecting,sorting and evaluating the retrieved literatures that met the inclusion criteria,in the hope of providing some evidence-based medical evidence support for clinicians and patients in the choice of treatment.Methods:According to the inclusion and exclusion criteria,qualified randomized controlled trials were screened out to be included in this study by searching Chinese and English databases.The software Review Manager 5.3 provided by Cochrane Library was used for literature quality risk assessment.Excel software was used to compile data information extraction table to extract,organize and statistical data.Review Manager 5.3software was used for meta-analysis using random effect model to systematically evaluate the effectiveness and safety of ¹²⁵I seed implantation in the treatment of intermediate and advanced NSCLC.At the same time,heterogeneity was analyzed.If the Chi-square test indicated I²≥50%,the cause of heterogeneity was analyzed;if I²<50%,heterogeneity was considered to be negligible.In bias analysis,funnel plot was used to determine publication bias.Results:Forty-three literatures,44 randomized controlled trials and a total of 3507 patients were included in the meta-analysis.Meta-analysis results suggested that in the treatment of solid tumors,the objective response rate and disease control rate of ¹²⁵I seed implantation in the treatment of advanced NSCLC were 1.52 times and 1.19 times higher than those of the control group,respectively.The 1-2 year survival rate analysis showed that the 1-year survival rate and 2-year survival rate of ¹²⁵I seed implantation in the treatment of advanced NSCLC could be increased by 18%and 20%respectively compared with the control group.In terms of the incidence of complications,compared with the control group,the incidence rates of bone marrow suppression,radioactive lung injury and radioactive esophagitis were reduced to 78%,37%and 18%,respectively,with ¹²⁵I seed implantation in the treatment of advanced NSCLC,but the risk of pneumothorax,particle migration and bleeding related adverse reactions was increased.Meanwhile,compared with the control group,¹²⁵I seed implantation did not increase the incidence of leukopenia,thrombocytopenia,nausea,vomiting,diarrhea,and gastrointestinal reactions in the treatment of advanced NSCLC.Conclusion:¹²⁵I seed implantation can improve the objective remission rate and disease control rate of patients with advanced NSCLC,prolong the1-2-year survival rate,and reduce the incidence of adverse reactions such as bone marrow suppression and radiation-induced lung injury.It can be employed as an effective and relatively safe method for the treatment of patients with advanced NSCLC,but it will increase the risk of adverse reactions related to pneumothorax,particle migration and bleeding.