Impact of target area selection in 125 I odine seed brachytherapy on locoregional recurrence in patients with non‐small cell lung cancer

• Published in: Thoracic cancer Vol. 8; no. 3; pp. 147 - 152
• Main Authors: Yan, Wei‐Liang, Lv, Jin‐Shuang, Guan, Zhi‐Yu, Wang, Li‐Yang, Yang, Jing‐Kui, Liang, Ji‐Xiang
• Format: Journal Article
• Language: English
• Published: Tianjin John Wiley & Sons, Inc 01.05.2017
• Subjects: Cancer therapies; Lung cancer; Medical imaging; Metastasis; Radiation therapy; Tumors; United States > US; China
• ISSN: 1759-7706; 1759-7714
• DOI: 10.1111/1759-7714.12415

Background Computed tomography (CT )‐guided percutaneous implantation of 125 Iodine radioactive seeds requires the precise arrangement of seeds by tumor shape. We tested whether selecting target areas, including subclinical areas around tumors, can influence locoregional recurrence in patients with non‐small cell lung cancer ( NSCLC ). Method We divided 82 patients with NSCLC into two groups. Target areas in g roup 1 ( n  = 40) were defined along tumor margins based on lung‐window CT . Target areas in g roup 2 ( n  = 42) were extended by 0.5 cm in all dimensions outside tumor margins. Preoperative plans for both groups were based on a treatment plan system, which guided 125 I seed implantation. Six months later, patients underwent chest CT to evaluate treatment efficacy (per R esponse E valuation C riteria in S olid T umors version 1). We compared locoregional recurrences between the g roups after a year of follow‐up. We then used the treatment plan system to extend target areas for g roup 1 patients by 0.5 cm (defined as g roup 3 data) and compared these hypothetical g roup 3 planned seeds with the actual seed numbers used in g roup 1 patients. Results All patients successfully underwent implantation; none died during the follow‐up period. Recurrence was significantly lower in g roup 2 than in g roup 1 ( P  < 0.05). G roup 1 patients and g roup 3 data significantly differed in seed numbers ( P  < 0.01). Conclusion Our results imply that extending the implantation area for 125 I seeds can decrease recurrence risk by eradicating cancerous lymph‐duct blockades within the extended areas.