Huo Bin,Huo Xiaodong,Wang Lei,Cao Qiang,Wang Jinhuan,Wang Lili,Zang Li,Wang Haitao,Chai Shude,Wang Junjie.CT and template-guided radioactive seed implantation for inoperable early stage non-small cell lung cancer[J].Chinese Journal of Radiological Medicine and Protection,2017,37(7):500-504
CT and template-guided radioactive seed implantation for inoperable early stage non-small cell lung cancer
Received:April 05, 2017  
DOI:10.3760/cma.j.issn.0254-5098.2017.07.005
KeyWords:Template  CT guided  Brachytherapy  Radioactive seeds implantation  Non small cell lung cancer(NSCLC)
FundProject:国家自然科学基金(81572543);天津市自然科学基金(15JCYBJC28400)
Author NameAffiliationE-mail
Huo Bin Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Huo Xiaodong Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Wang Lei Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Cao Qiang Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Wang Jinhuan Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Wang Lili Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Zang Li Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Wang Haitao Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China peterrock2000@126.com 
Chai Shude Department of Thoracic Surgery, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Wang Junjie Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China  
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Abstract::
      Objective To investigate the efficacy and side effects of radioactive seed implantation in the treatment of non-surgical early stage non-small cell lung cancer (NSCLC) based on CT guidance combined with template. Methods Twenty-one patients with inoperable T1-2N0M0 NSCLC who underwent CT-guided radioactive seed implantation therapy were retrospectively analyzed from December 2010 to October 2016 in the Second Hospital of Tianjin Medical University. All patients were diagnosed by histopathology. All seeds, with the activity of 18.5-29.6 MBq and prescription dose of 120-160 Gy, were completed in an operation of the radioactive seed implantation. The preoperative and postoperative TPS treatment plans and quality verification were corducted. In addition, the local control rate of tumors, overall survival (OS), progression free survival time (PFS), satisfaction rate of dose validation and adverse reactions were evaluated. Results The median follow-up was 25.1 months (range 4.4-72.7 months). The local control rate of primary tumor in 1-, 2- and 3-year was 100%, 95.2% and 95.2%, respectively. Of all patients, the median OS was 48 months with the median PFS 43.4 months. In particular, the 1-, 2- and 3-year survival rate was 100%, 91.7% and 72.9%, respectively. Moreover, the rate of 3-year PFS was 70.2% and the satisfactory rate of postoperative quality verification was 100%. The treatment-related adverse events included pneumothorax, bronchial hemorrhage, pleural effusion, cough, pulmonary fibrosis and seed shifts. In all, 7 (33.3%) patients had grade 1 adverse events and 4 (19%) patients with grade 2, but no grade 3 adverse event. Conclusions CT and template-guided radioactive seed implantation in NSCLC with T1-2N0M0 has a high tumor local control rate and low treatment-related adverse reactions, suggesting that it might provide an alternative way for the treatment of inoperable early stage NSCLC.
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