Combination of Iodine-125 brachytherapy and chemotherapy for locally recurrent stage III non-small cell lung cancer after concurrent chemoradiotherapy

BMC Cancer. 2015 Oct 6:15:656. doi: 10.1186/s12885-015-1657-3.

Abstract

Background: Locally recurrent non-small cell lung cancer (NSCLC) poses a great challenge to physicians. This study aimed to explore the efficacy and safety of the combination of brachytherapy and docetaxel and cisplatin for the treatment of locally recurrent stage III NSCLC.

Methods: Fifty two patients with locally recurrent stage III NSCLC after concurrent chemoradiotherapy were randomly divided into two groups (n = 26). The patients in experimental group were treated with implantation of radioactive (125)I seeds and DP regimen (docetaxel 60 mg/m(2)/cisplatin 75 mg/m(2)). Patients in control group received DP chemotherapy. The local control rate (LCR), progression-free survival (PFS), and overall response rate (ORR) were defined according to the Response Evaluation Criteria in Solid Tumors (RECIST).

Results: With a median follow-up time of 11 months, PFS and LCR was 8 months (95 % CI: 6.99-9.01 months) vs. 5.5 months (95 % CI: 4.43-6.57 months) (P < 0.05) and 10 months (95 % CI: 8.72-11.28 months) vs. 6.2 months (95 % CI: 5.27-7.13 months) (P < 0.05) in the experimental and control groups, respectively. The ORR did not differ between treatment groups and was noted to be 69.2 % and 57.7 %, respectively (P >0.05). There was no occurrence of severe complications in experimental and control groups.

Conclusion: The combination of (125)I brachytherapy and second-line chemotherapy is superior to chemotherapy alone and is an effective and safe therapy for this disease.

Trial registration number: ChiCTR-IOR-15006560.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Brachytherapy* / adverse effects
  • Brachytherapy* / methods
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Carcinoma, Non-Small-Cell Lung / therapy*
  • Chemoradiotherapy
  • Female
  • Follow-Up Studies
  • Humans
  • Iodine Radioisotopes / therapeutic use*
  • Kaplan-Meier Estimate
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / therapy*
  • Male
  • Neoplasm Grading
  • Neoplasm Staging
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Tumor Burden

Substances

  • Iodine Radioisotopes