Clinical Investigation
Value of 125I seed implantation for patients with oligometastatic EGFR-mutant non-small cell lung cancer without progression after first-line EGFR-TKIs treatment
Wang Meng, Zhou Zhigang, Du Kepu, Li Shuai, Li Yadan, Gao Fei, Gao Jianbo
Published 2023-07-25
Cite as Chin J Nucl Med Mol Imaging, 2023, 43(7): 402-406. DOI: 10.3760/cma.j.cn321828-20211213-00439
Abstract
ObjectiveTo explore the clinical efficacy of CT-guided 125I seed implantation in patients with oligometastatic non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) activating mutations (EGFRm+ ) without progression after first-line EGFR-tyrosine kinase inhibitors (TKIs) treatment.
MethodsFrom January 2015 to January 2019, 89 eligible patients (38 males, 51 females; age: (62±11) years) in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. They were divided into 2 groups according to different treatment methods. The 125I seeds were implanted for oligometastatic lesions and/or primary tumors without progression after first-line EGFR-TKIs therapy in local consolidation treatment group (Group A, n=32). The maintenance treatment group (Group B, n=57) only received EGFR-TKIs until disease progression. The progression-free survival (PFS) and overall survival (OS) of the 2 groups were estimated by Kaplan-Meier curves, and were compared by using log-rank test. Complications in Group A were observed.
ResultsThe follow-up time of the group A and group B were 36.5(31.0, 43.3) months and 30.0(24.0, 35.0) months respectively. The median PFS and OS in group A were 15.0(95% CI: 12.8-17.2 ) months and 37.0(95% CI: 33.9-40.1) months, both of which were significantly longer than those in group B (12.0(95% CI: 10.9-13.1) months and 31.0(95% CI: 28.9-33.1) months; χ2 values: 8.80, 7.15, P values: 0.003, 0.007). In Group A, the total incidence of complications in CT-guided 125I seed implantation was 21.9%(7/32), and the common complications and adverse events were pneumothorax and hemoptysis. Only 1 patient underwent chest tube insertion, and the rest were treated with conservative treatment. No operation related death occurred.
ConclusionCT-guided 125I seed implantation is safe and feasible for patients with EGFRm+ oligometastatic NSCLC without progression after first-line EGFR-TKIs treatment, and can prolong the PFS and OS of patients.
Key words:
Carcinoma, non-small-cell lung; Brachytherapy; Iodine radioisotopes; Receptor, epidermal growth factor
Contributor Information
Wang Meng
Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Zhou Zhigang
Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Du Kepu
Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Li Shuai
Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Li Yadan
Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Gao Fei
Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
Gao Jianbo
Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
