CT-guided Radioactive ¹²⁵I Seed Implantation For Oligorecurrence Non-small Cell Lung Cancer After Failure Of First-line Chemotherapy

Purpose:To compare the efficacy and safety of CT-guided ¹²⁵I seed implantation with second-line chemotherapy in the treatment of oligorecurrence non-small cell lung cancer after failure of first-line chemotherapy.Materials and Methods:Data of oligorecurrence non-small cell lung cancer patients after failure of first-line chemotherapy at two institutions were retrospectively reviewed from January 2013 to July 2018.A total of 53 patients who received the treatment of ¹²⁵I seed implantation or second-line chemotherapy were eligible for this study.In Group A,25 patients,84 lesions,received CT-guided permanent ¹²⁵I seed implantation,while in Group B,28 patients,96 lesions,received second-line chemotherapy.Follow-up of all patients were carried out at an interval of 2 months.The outcomes were measured in terms of disease control rate,overall survival,quality of life,and complications.Results:The median follow-up period was 13 months（range 5–42 months）.At the2^nd,4^th,and 6^th months after treatment,Disease control rate in Group A versus Group B was 76.0%versus 75.0%（p=0.933）,72.0%versus 55.6%（p=0.219）,and 70.8%versus 42.3%（p=0.042）.Disease control rate in Group A was higher than that in Group B at 6th months after treatment.The 1-year and 2-year overall survival rates were 59.5%and 23.9%in group A,while 62.6%and 22.3%in group B,respectively.The median survival was 12.8 months（95%confidence interval 10.5–15.1）in Group A and 15.2 months（95%confidence interval 12.2–18.2）in Group B,with no significant difference（p=0.847）.At the 2^nd,4^th,and 6^th months after treatment,the number of patients with non-decreasing Karnofsky Performance Score（increase and stable）in Group A versus Group B was 88.0%versus 71.4%（p=0.138）,72.0%versus 48.1%（p=0.044）,and 62.5%versus 30.8%（p=0.025）.Since the 4^th month,the number of patients in Group A with a non-decreasing Karnofsky Performance Score was more than that in Group B.The incidence of grade 3 or higher complications in Group A was lower than that in Group B（p<0.05）.Conclusion:Radioactive ¹²⁵I seed implantation is safe and feasible in selected non-small cell lung cancer patients with oligorecurrence after failure of first-line chemotherapy,and seems to provide a better long-term quality of life in these patients compared to second-line chemotherapy.