Intraoperative (125)I Vicryl mesh brachytherapy after sublobar resection for high-risk stage I non-small cell lung cancer

Brachytherapy. 2005;4(4):278-85. doi: 10.1016/j.brachy.2005.03.007.


Purpose: To assess the feasibility and outcomes of (125)I Vicryl mesh brachytherapy after sublobar resection in stage I non small cell lung cancer (NSCLC) patients with poor pulmonary function.

Methods and materials: Between January 1997 and July 2004, patients with poor cardiopulmonary reserve who had stage IA and IB (T1-2 N0 M0) NSCLC and a forced expiratory volume in 1s (FEV(1)) of > micro=0.6L were considered for limited surgical resection either by an open or video-assisted thoracoscopic procedure and for a subsequent (125)I Vicryl mesh brachytherapy implant. Mediastinal and hilar lymph node staging was performed routinely in all patients. After clear margins were obtained grossly and on frozen section, a single-plane (125)I implant was designed to encompass a plane consisting of the staple line and a 2-cm margin of surrounding visceral pleura. The implant was introduced through the surgical incision and sutured to the visceral pleura. A prescribed dose of 100-120 y was delivered to a volume within 0.5 cm rom the plane of the implant. Follow-up orthogonal films or CTs were obtained for dosimetric analysis. Kaplan-Meier analyses were used to estimate the local control, locoregional control, and overall survival rates.

Results: Of the 110 patients, 65 had stage IA and 45 had stage IB NSCLC. The mean preoperative FEV(1) was 47% of the predicted volume. With a median follow-up of 11 months (range 1-68 months), there were four recurrences within the radiation volume. The estimated 5-year local (in-field) control, locoregional control, and overall survival rates were 90%, 61%, and 18%, respectively.

Conclusion: Vicryl mesh brachytherapy after sublobar resection for high-risk stage I NSCLC patients is a feasible procedure, which results in an excellent local (in-field) control rate.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brachytherapy*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / physiopathology
  • Carcinoma, Non-Small-Cell Lung / radiotherapy
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Carcinoma, Non-Small-Cell Lung / therapy*
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume
  • Humans
  • Intraoperative Care*
  • Iodine Radioisotopes / administration & dosage
  • Iodine Radioisotopes / therapeutic use*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / physiopathology
  • Lung Neoplasms / radiotherapy
  • Lung Neoplasms / surgery
  • Lung Neoplasms / therapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / prevention & control
  • Neoplasm Staging
  • Pneumonectomy* / adverse effects
  • Pneumonectomy* / methods
  • Polyglactin 910 / administration & dosage
  • Polyglactin 910 / therapeutic use*
  • Risk Factors
  • Survival Analysis
  • Thoracic Surgery, Video-Assisted
  • Thoracotomy
  • Time Factors
  • Treatment Outcome


  • Iodine Radioisotopes
  • Polyglactin 910