Oligorecurrence Non-small Cell Lung Cancer After Failure of First-Line Chemotherapy: Computed Tomography-Guided 125I Seed Implantation vs. Second-Line Chemotherapy

Hao Wang; Jian Lu; Xiao-Ting Zheng; Jun-Hao Zha; Wen-Dong Jing; Yong Wang; Guang-Yu Zhu; Chu-Hui Zeng; Lei Chen; Jin-He Guo

doi:10.3389/fonc.2020.00470

Oligorecurrence Non-small Cell Lung Cancer After Failure of First-Line Chemotherapy: Computed Tomography-Guided ¹²⁵I Seed Implantation vs. Second-Line Chemotherapy

Front Oncol. 2020 Apr 15:10:470. doi: 10.3389/fonc.2020.00470. eCollection 2020.

Authors

Affiliations

¹ Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
² Center of Oncology, Tianchang City Hospital of Chinese Medicine, Chuzhou, China.
³ Department of Intervention and Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.

Abstract

Purpose: To compare the efficacy and safety of computed tomography (CT)-guided ¹²⁵I seed implantation with second-line chemotherapy in treatment of oligorecurrence non-small cell lung cancer after failure of first-line chemotherapy. 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, whereas in group B, 28 patients, 96 lesions, received second-line chemotherapy. 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). Disease control rate in group A was higher than that in group B (70.8 vs. 42.3%, P = 0.042) at 6 months after treatment. The median overall survival was 12.8 months (95% confidence interval, 10.5-15.1 months) in group A and 15.2 months (95% confidence interval, 12.2-18.2 months) in group B, with no significant difference (P = 0.847). Since the fourth month, the number of patients in group A with a non-decreasing Karnofsky Performance Scale score was more than that in group B (P < 0.05). The incidence of grade 3 or higher complications especially hematologic toxicity in group A was significantly 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 with second-line chemotherapy.

Keywords: 125I seed implantation; brachytherapy; chemotherapy; non–small cell lung cancer; oligometastases; oligorecurrence.