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CT-guided interstitial brachytherapy of inoperable non-small cell lung cancer
Abstract Purpose The aim of this study was to assess the technical feasibility, efficacy, and complications of CT-guided interstitial brachytherapy for treating inoperable non-small cell lung cancer (NSCLC). Materials and methods Twenty one patients were included in this prospective study. The media...
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Published in: | Lung cancer (Amsterdam, Netherlands) Netherlands), 2011-11, Vol.74 (2), p.253-257 |
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description | Abstract Purpose The aim of this study was to assess the technical feasibility, efficacy, and complications of CT-guided interstitial brachytherapy for treating inoperable non-small cell lung cancer (NSCLC). Materials and methods Twenty one patients were included in this prospective study. The median age was 72.6 years (57–85). Tumors were treated with brachytherapy that was positioned under CT-fluoroscopy. The treatment planning system (TPS) was used preoperatively to reconstruct three dimensional images of the tumor and to calculate the estimated seed number and distribution. The median matched peripheral dose (MPD) was 130 Gy (range, 100–160 Gy). All procedures were performed under local anesthesia. A follow-up CT was performed 6 weeks later and every 3 months post implantation. Results Follow-up period was 2–30 months. The mean diameter of the 21 lung tumors was 4.6 cm (range, 2.8–6.5 cm). The response rate of pain relief was 83.3% (10/12). The pain-free duration was 0–12 months (median: 6 months; 95% CI: 3–9 months). Overall responding rate (CR + PR) for this group of patients was 71.4%. Local tumor control rate was 85.7%. Six (28.6%) patients died as a result of primary tumor progression; thirteen (61.9%) patients died of multi-organ failure or other metastases. Two (9.5%) patients survived to follow-up. At the time of analysis, the median survival time for all patients was 10 months (95% CI: 6.6–13.4 months), with 1 year and 2 year survival rates were 42.4% and 6.5%, respectively. Median survival time for stage II, stage III, and stage IV was 20 months, 9 months, and 8 months, respectively. No major complications were observed. Minor complications (19%) included mild pneumothorax ( n = 1), hemosputum ( n = 1), pleural effusion ( n = 1), and localized skin erythema ( n = 1). None of these complications required further treatment, although hospital discharge was delayed. No125 I seeds migrated to other tissues or organs. Conclusion Minimally invasive CT-guided interstitial brachytherapy is safe, useful, less complicated and considered as a palliative treatment option for inoperable non-small cell lung cancer. |
doi_str_mv | 10.1016/j.lungcan.2011.03.006 |
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fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_898508172</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S016950021100167X</els_id><sourcerecordid>898508172</sourcerecordid><originalsourceid>FETCH-LOGICAL-c449t-658f5162178b617877514ef8a9f7e5590eeaea458781b10e04be9a44b818d3073</originalsourceid><addsrcrecordid>eNqFkU1v1DAQhq0K1G4LPwGUC-KUMBPHsX0pQiv6IRVxoEjcLMeZtF6yyWInSPvvcbRbKnHhYsvyMzOvnmHsDUKBgPWHTdHPw4OzQ1ECYgG8AKhP2AqVLHPFefmCrRKncwFQnrHzGDcAKBH0KTsrUSDXWq7Yl_V9_jD7ltrMDxOFOPnJ2z5rgnWP--mRgt3ts7FLv-MuPZqesmEc8ri1fZ85SseSI0tBHIVX7GVn-0ivj_cF-371-X59k999vb5df7rLXVXpKa-F6gTWJUrV1OmQUmBFnbK6kySEBiJLthJKKmwQCKqGtK2qRqFqOUh-wd4f-u7C-GumOJmtj0sYO9A4R6O0EqBQlokUB9KFMcZAndkFv7VhbxDMItJszFGkWUQa4CaJTHVvjxPmZkvt36oncwl4dwRsdLbvQhLg4zNX1bwGCYn7eOAo-fjtKZjoPCVZrQ_kJtOO_r9RLv_p4Ho_-DT0J-0pbsY5DEm2QRNLA-bbsvVl6Yhp4bX8wf8AWiin6w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>898508172</pqid></control><display><type>article</type><title>CT-guided interstitial brachytherapy of inoperable non-small cell lung cancer</title><source>ScienceDirect Freedom Collection</source><creator>Wang, Zhong-Min ; Lu, Jian ; Liu, Tao ; Chen, Ke-Min ; Huang, Gang ; Liu, Fen-Ju</creator><creatorcontrib>Wang, Zhong-Min ; Lu, Jian ; Liu, Tao ; Chen, Ke-Min ; Huang, Gang ; Liu, Fen-Ju</creatorcontrib><description>Abstract Purpose The aim of this study was to assess the technical feasibility, efficacy, and complications of CT-guided interstitial brachytherapy for treating inoperable non-small cell lung cancer (NSCLC). Materials and methods Twenty one patients were included in this prospective study. The median age was 72.6 years (57–85). Tumors were treated with brachytherapy that was positioned under CT-fluoroscopy. The treatment planning system (TPS) was used preoperatively to reconstruct three dimensional images of the tumor and to calculate the estimated seed number and distribution. The median matched peripheral dose (MPD) was 130 Gy (range, 100–160 Gy). All procedures were performed under local anesthesia. A follow-up CT was performed 6 weeks later and every 3 months post implantation. Results Follow-up period was 2–30 months. The mean diameter of the 21 lung tumors was 4.6 cm (range, 2.8–6.5 cm). The response rate of pain relief was 83.3% (10/12). The pain-free duration was 0–12 months (median: 6 months; 95% CI: 3–9 months). Overall responding rate (CR + PR) for this group of patients was 71.4%. Local tumor control rate was 85.7%. Six (28.6%) patients died as a result of primary tumor progression; thirteen (61.9%) patients died of multi-organ failure or other metastases. Two (9.5%) patients survived to follow-up. At the time of analysis, the median survival time for all patients was 10 months (95% CI: 6.6–13.4 months), with 1 year and 2 year survival rates were 42.4% and 6.5%, respectively. Median survival time for stage II, stage III, and stage IV was 20 months, 9 months, and 8 months, respectively. No major complications were observed. Minor complications (19%) included mild pneumothorax ( n = 1), hemosputum ( n = 1), pleural effusion ( n = 1), and localized skin erythema ( n = 1). None of these complications required further treatment, although hospital discharge was delayed. No125 I seeds migrated to other tissues or organs. Conclusion Minimally invasive CT-guided interstitial brachytherapy is safe, useful, less complicated and considered as a palliative treatment option for inoperable non-small cell lung cancer.</description><identifier>ISSN: 0169-5002</identifier><identifier>EISSN: 1872-8332</identifier><identifier>DOI: 10.1016/j.lungcan.2011.03.006</identifier><identifier>PMID: 21513997</identifier><identifier>CODEN: LUCAE5</identifier><language>eng</language><publisher>Oxford: Elsevier Ireland Ltd</publisher><subject>125I seed ; Administration, Cutaneous ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Brachytherapy - adverse effects ; Brachytherapy - methods ; Bronchi - pathology ; Bronchi - radiation effects ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - physiopathology ; Carcinoma, Non-Small-Cell Lung - radiotherapy ; CT-guided intervention ; Disease Progression ; Feasibility Studies ; Female ; Follow-Up Studies ; Hematology, Oncology and Palliative Medicine ; Humans ; Inoperable non-small cell lung cancer (NSCLC) ; Interstitial brachytherapy ; Iodine Isotopes - therapeutic use ; Lung Neoplasms - mortality ; Lung Neoplasms - pathology ; Lung Neoplasms - physiopathology ; Lung Neoplasms - radiotherapy ; Male ; Medical sciences ; Middle Aged ; Minimally Invasive Surgical Procedures - methods ; Neoplasm Staging ; Pain ; Palliative Care - methods ; Pleural Effusion - etiology ; Pneumology ; Pneumothorax - etiology ; Pulmonary/Respiratory ; Survival Analysis ; Tumors ; Tumors of the respiratory system and mediastinum</subject><ispartof>Lung cancer (Amsterdam, Netherlands), 2011-11, Vol.74 (2), p.253-257</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2011 Elsevier Ireland Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c449t-658f5162178b617877514ef8a9f7e5590eeaea458781b10e04be9a44b818d3073</citedby><cites>FETCH-LOGICAL-c449t-658f5162178b617877514ef8a9f7e5590eeaea458781b10e04be9a44b818d3073</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24636070$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21513997$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Zhong-Min</creatorcontrib><creatorcontrib>Lu, Jian</creatorcontrib><creatorcontrib>Liu, Tao</creatorcontrib><creatorcontrib>Chen, Ke-Min</creatorcontrib><creatorcontrib>Huang, Gang</creatorcontrib><creatorcontrib>Liu, Fen-Ju</creatorcontrib><title>CT-guided interstitial brachytherapy of inoperable non-small cell lung cancer</title><title>Lung cancer (Amsterdam, Netherlands)</title><addtitle>Lung Cancer</addtitle><description>Abstract Purpose The aim of this study was to assess the technical feasibility, efficacy, and complications of CT-guided interstitial brachytherapy for treating inoperable non-small cell lung cancer (NSCLC). Materials and methods Twenty one patients were included in this prospective study. The median age was 72.6 years (57–85). Tumors were treated with brachytherapy that was positioned under CT-fluoroscopy. The treatment planning system (TPS) was used preoperatively to reconstruct three dimensional images of the tumor and to calculate the estimated seed number and distribution. The median matched peripheral dose (MPD) was 130 Gy (range, 100–160 Gy). All procedures were performed under local anesthesia. A follow-up CT was performed 6 weeks later and every 3 months post implantation. Results Follow-up period was 2–30 months. The mean diameter of the 21 lung tumors was 4.6 cm (range, 2.8–6.5 cm). The response rate of pain relief was 83.3% (10/12). The pain-free duration was 0–12 months (median: 6 months; 95% CI: 3–9 months). Overall responding rate (CR + PR) for this group of patients was 71.4%. Local tumor control rate was 85.7%. Six (28.6%) patients died as a result of primary tumor progression; thirteen (61.9%) patients died of multi-organ failure or other metastases. Two (9.5%) patients survived to follow-up. At the time of analysis, the median survival time for all patients was 10 months (95% CI: 6.6–13.4 months), with 1 year and 2 year survival rates were 42.4% and 6.5%, respectively. Median survival time for stage II, stage III, and stage IV was 20 months, 9 months, and 8 months, respectively. No major complications were observed. Minor complications (19%) included mild pneumothorax ( n = 1), hemosputum ( n = 1), pleural effusion ( n = 1), and localized skin erythema ( n = 1). None of these complications required further treatment, although hospital discharge was delayed. No125 I seeds migrated to other tissues or organs. Conclusion Minimally invasive CT-guided interstitial brachytherapy is safe, useful, less complicated and considered as a palliative treatment option for inoperable non-small cell lung cancer.</description><subject>125I seed</subject><subject>Administration, Cutaneous</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Brachytherapy - adverse effects</subject><subject>Brachytherapy - methods</subject><subject>Bronchi - pathology</subject><subject>Bronchi - radiation effects</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - physiopathology</subject><subject>Carcinoma, Non-Small-Cell Lung - radiotherapy</subject><subject>CT-guided intervention</subject><subject>Disease Progression</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Inoperable non-small cell lung cancer (NSCLC)</subject><subject>Interstitial brachytherapy</subject><subject>Iodine Isotopes - therapeutic use</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - physiopathology</subject><subject>Lung Neoplasms - radiotherapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Neoplasm Staging</subject><subject>Pain</subject><subject>Palliative Care - methods</subject><subject>Pleural Effusion - etiology</subject><subject>Pneumology</subject><subject>Pneumothorax - etiology</subject><subject>Pulmonary/Respiratory</subject><subject>Survival Analysis</subject><subject>Tumors</subject><subject>Tumors of the respiratory system and mediastinum</subject><issn>0169-5002</issn><issn>1872-8332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNqFkU1v1DAQhq0K1G4LPwGUC-KUMBPHsX0pQiv6IRVxoEjcLMeZtF6yyWInSPvvcbRbKnHhYsvyMzOvnmHsDUKBgPWHTdHPw4OzQ1ECYgG8AKhP2AqVLHPFefmCrRKncwFQnrHzGDcAKBH0KTsrUSDXWq7Yl_V9_jD7ltrMDxOFOPnJ2z5rgnWP--mRgt3ts7FLv-MuPZqesmEc8ri1fZ85SseSI0tBHIVX7GVn-0ivj_cF-371-X59k999vb5df7rLXVXpKa-F6gTWJUrV1OmQUmBFnbK6kySEBiJLthJKKmwQCKqGtK2qRqFqOUh-wd4f-u7C-GumOJmtj0sYO9A4R6O0EqBQlokUB9KFMcZAndkFv7VhbxDMItJszFGkWUQa4CaJTHVvjxPmZkvt36oncwl4dwRsdLbvQhLg4zNX1bwGCYn7eOAo-fjtKZjoPCVZrQ_kJtOO_r9RLv_p4Ho_-DT0J-0pbsY5DEm2QRNLA-bbsvVl6Yhp4bX8wf8AWiin6w</recordid><startdate>20111101</startdate><enddate>20111101</enddate><creator>Wang, Zhong-Min</creator><creator>Lu, Jian</creator><creator>Liu, Tao</creator><creator>Chen, Ke-Min</creator><creator>Huang, Gang</creator><creator>Liu, Fen-Ju</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20111101</creationdate><title>CT-guided interstitial brachytherapy of inoperable non-small cell lung cancer</title><author>Wang, Zhong-Min ; Lu, Jian ; Liu, Tao ; Chen, Ke-Min ; Huang, Gang ; Liu, Fen-Ju</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c449t-658f5162178b617877514ef8a9f7e5590eeaea458781b10e04be9a44b818d3073</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>125I seed</topic><topic>Administration, Cutaneous</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Brachytherapy - adverse effects</topic><topic>Brachytherapy - methods</topic><topic>Bronchi - pathology</topic><topic>Bronchi - radiation effects</topic><topic>Carcinoma, Non-Small-Cell Lung - mortality</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - physiopathology</topic><topic>Carcinoma, Non-Small-Cell Lung - radiotherapy</topic><topic>CT-guided intervention</topic><topic>Disease Progression</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Inoperable non-small cell lung cancer (NSCLC)</topic><topic>Interstitial brachytherapy</topic><topic>Iodine Isotopes - therapeutic use</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - physiopathology</topic><topic>Lung Neoplasms - radiotherapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>Neoplasm Staging</topic><topic>Pain</topic><topic>Palliative Care - methods</topic><topic>Pleural Effusion - etiology</topic><topic>Pneumology</topic><topic>Pneumothorax - etiology</topic><topic>Pulmonary/Respiratory</topic><topic>Survival Analysis</topic><topic>Tumors</topic><topic>Tumors of the respiratory system and mediastinum</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Zhong-Min</creatorcontrib><creatorcontrib>Lu, Jian</creatorcontrib><creatorcontrib>Liu, Tao</creatorcontrib><creatorcontrib>Chen, Ke-Min</creatorcontrib><creatorcontrib>Huang, Gang</creatorcontrib><creatorcontrib>Liu, Fen-Ju</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Lung cancer (Amsterdam, Netherlands)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Zhong-Min</au><au>Lu, Jian</au><au>Liu, Tao</au><au>Chen, Ke-Min</au><au>Huang, Gang</au><au>Liu, Fen-Ju</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>CT-guided interstitial brachytherapy of inoperable non-small cell lung cancer</atitle><jtitle>Lung cancer (Amsterdam, Netherlands)</jtitle><addtitle>Lung Cancer</addtitle><date>2011-11-01</date><risdate>2011</risdate><volume>74</volume><issue>2</issue><spage>253</spage><epage>257</epage><pages>253-257</pages><issn>0169-5002</issn><eissn>1872-8332</eissn><coden>LUCAE5</coden><abstract>Abstract Purpose The aim of this study was to assess the technical feasibility, efficacy, and complications of CT-guided interstitial brachytherapy for treating inoperable non-small cell lung cancer (NSCLC). Materials and methods Twenty one patients were included in this prospective study. The median age was 72.6 years (57–85). Tumors were treated with brachytherapy that was positioned under CT-fluoroscopy. The treatment planning system (TPS) was used preoperatively to reconstruct three dimensional images of the tumor and to calculate the estimated seed number and distribution. The median matched peripheral dose (MPD) was 130 Gy (range, 100–160 Gy). All procedures were performed under local anesthesia. A follow-up CT was performed 6 weeks later and every 3 months post implantation. Results Follow-up period was 2–30 months. The mean diameter of the 21 lung tumors was 4.6 cm (range, 2.8–6.5 cm). The response rate of pain relief was 83.3% (10/12). The pain-free duration was 0–12 months (median: 6 months; 95% CI: 3–9 months). Overall responding rate (CR + PR) for this group of patients was 71.4%. Local tumor control rate was 85.7%. Six (28.6%) patients died as a result of primary tumor progression; thirteen (61.9%) patients died of multi-organ failure or other metastases. Two (9.5%) patients survived to follow-up. At the time of analysis, the median survival time for all patients was 10 months (95% CI: 6.6–13.4 months), with 1 year and 2 year survival rates were 42.4% and 6.5%, respectively. Median survival time for stage II, stage III, and stage IV was 20 months, 9 months, and 8 months, respectively. No major complications were observed. Minor complications (19%) included mild pneumothorax ( n = 1), hemosputum ( n = 1), pleural effusion ( n = 1), and localized skin erythema ( n = 1). None of these complications required further treatment, although hospital discharge was delayed. No125 I seeds migrated to other tissues or organs. Conclusion Minimally invasive CT-guided interstitial brachytherapy is safe, useful, less complicated and considered as a palliative treatment option for inoperable non-small cell lung cancer.</abstract><cop>Oxford</cop><pub>Elsevier Ireland Ltd</pub><pmid>21513997</pmid><doi>10.1016/j.lungcan.2011.03.006</doi><tpages>5</tpages></addata></record> |
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subjects | 125I seed Administration, Cutaneous Aged Aged, 80 and over Biological and medical sciences Brachytherapy - adverse effects Brachytherapy - methods Bronchi - pathology Bronchi - radiation effects Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - physiopathology Carcinoma, Non-Small-Cell Lung - radiotherapy CT-guided intervention Disease Progression Feasibility Studies Female Follow-Up Studies Hematology, Oncology and Palliative Medicine Humans Inoperable non-small cell lung cancer (NSCLC) Interstitial brachytherapy Iodine Isotopes - therapeutic use Lung Neoplasms - mortality Lung Neoplasms - pathology Lung Neoplasms - physiopathology Lung Neoplasms - radiotherapy Male Medical sciences Middle Aged Minimally Invasive Surgical Procedures - methods Neoplasm Staging Pain Palliative Care - methods Pleural Effusion - etiology Pneumology Pneumothorax - etiology Pulmonary/Respiratory Survival Analysis Tumors Tumors of the respiratory system and mediastinum |
title | CT-guided interstitial brachytherapy of inoperable non-small cell lung cancer |
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