Clinical outcomes of intra-arterial chemotherapy combined with iodine-125 seed brachytherapy in the treatment of malignant superior vena cava syndrome caused by small cell lung cancer

Y Wang; F Li; Y Hu; Y Sun; C Tian; Y Cao; W Wang; W Feng; J Yan; J Wei; X Du; H Wang

doi:10.1016/j.canrad.2023.01.008

Clinical outcomes of intra-arterial chemotherapy combined with iodine-125 seed brachytherapy in the treatment of malignant superior vena cava syndrome caused by small cell lung cancer

Cancer Radiother. 2023 Jun;27(4):312-318. doi: 10.1016/j.canrad.2023.01.008. Epub 2023 May 23.

Authors

Y Wang¹, F Li², Y Hu³, Y Sun⁴, C Tian¹, Y Cao¹, W Wang⁵, W Feng¹, J Yan¹, J Wei¹, X Du¹, H Wang⁶

Affiliations

¹ Department of Melanoma Oncology, Tianjin BeiChen Hospital, Beiyi Road, Beichen District, 300400 Tianjin, China.
² Department of Melanoma Oncology, Tianjin BeiChen Hospital, Beiyi Road, Beichen District, 300400 Tianjin, China; Core Laboratory, Tianjin BeiChen Hospital, Beiyi Road, Beichen District, 300400 Tianjin, China. Electronic address: rosetea85@163.com.
³ Department of Melanoma Oncology, Tianjin BeiChen Hospital, Beiyi Road, Beichen District, 300400 Tianjin, China; Shanxi Mecidal University, Graduate Research Institute, 030604 Shanxi, China.
⁴ Department of Melanoma, University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA.
⁵ Department of Pathology, Tianjin BeiChen Hospital, Beiyi Road, Beichen District, 300400 Tianjin, China.
⁶ Department of Oncology, Tianjin Union Medical Center, 300191 Tianjin, China; Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China.

PMID: 37230904
DOI: 10.1016/j.canrad.2023.01.008

Abstract

Purpose: Currently there is a lack of effective treatment strategies for malignant superior vena cava syndrome (SVCS). We aim to investigate the therapeutic effect of intra-arterial chemotherapy (IAC) combined with the Single Needle Cone Puncture method for the ¹²⁵I brachytherapy (SNCP-¹²⁵I) in treating SVCS caused by stage III/IV Small Cell Lung Cancer (SCLC).

Materials and methods: Sixty-two patients with SCLC who developed SVCS from January 2014 to October 2020 were investigated in this study. Out of these 62 patients, 32 underwent IAC combined with SNCP-¹²⁵I (Group A) and 30 patients received IAC treatment only (Group B). Clinical symptom remission, response rate, disease control rate, and overall survival of these two groups of patients were analyzed and compared.

Results: The remission rate of symptoms including dyspnea, edema, dysphagia, pectoralgia, and cough of malignant SVCS in Group A was significantly higher than that in Group B (70.5 and 50.53%, P=0.0004, respectively). The disease control rates (DCR, PR+CR+SD) of Group A and B were 87.5 and 66.7%, respectively (P=0.049). Response rates (RR, PR+CR) of Group A and Group B were 71.9 and 40% (P=0.011). The median overall survival (OS) of Group A was significantly longer than that in Group B which was 18 months compared to 11.75 months (P=0.0360).

Conclusions: IAC treatment effectively treated malignant SVCS in advanced SCLC patients. IAC combined with SNCP-¹²⁵I in the treatment of malignant SVCS caused by SCLC showed improved clinical outcomes including symptom remission and local tumor control rates than IAC treatment only in treating SCLC-induced malignant SVCS.

Keywords: Cancer du poumon à petites cellules; Chimiothérapie intra-artérielle; Intra-arterial chemotherapy; SNCP-(125)I; Small cell lung cancer; Superior vena cava syndrome; Syndrome de la veine cave supérieure.

MeSH terms

Brachytherapy* / adverse effects
Humans
Lung Neoplasms* / drug therapy
Lung Neoplasms* / therapy
Small Cell Lung Carcinoma* / complications
Small Cell Lung Carcinoma* / radiotherapy
Superior Vena Cava Syndrome* / etiology
Superior Vena Cava Syndrome* / therapy

Substances

Iodine-125