Objective: To explore influential factors of local therapeutic effect in CT guided brachytherapy of (125)I seeds for non-small-cell lung carcinoma (NSCLC).
Methods: Totally 141 primary NSCLC patients diagnosed by bronchoscope or puncture biopsy were treated with CT guided (125)I seeds implantation treatment from 2003 January to 2005 January. Among them, 26 patients were treated with seeds implantation only and remaining 115 combined with chemical therapy. Preplans were performed by using treatment planning system before the implantation. We took the implantation with the prescription dose of 80 - 110 Gy, 1 seed per 1 cm(3), under the guide of computed tomography. Six months after implantation treatment, CT graphs were taken to evaluate the therapeutic effect.
Results: All the patients were survival until 6 months after implantation, and 37 were complete remission, 93 were partial remissions. The effective rate was 92.2%. Among all the observed factors, pathologic type(F = 5.162, P = 0.023), dose of cover 100% tumor (D(100)) (F = 100.713, P = 0.000) and treatment methods (F = 16.205, P = 0.000) were the independent influent factors (P < 0.05). Among these, D(100) was the most important factor (P = 0.000). Single factor analysis indicated that pathologic type (χ(2) = 7.313, P = 0.007), D(100) (χ(2) = 71.6, P = 0.000) and treatment methods (χ(2) = 20.5, P = 0.000) were significant influent factors. Of all 141 cases, 24 had complications during or after implantation treatment, while no severe complications were reported. There was no significant correlation between complication and local therapeutic effect (P > 0.05).
Conclusion: CT guided implantation of (125)I seeds for lung cancer has good clinical effects and few complications. D(100) is the most important factor to influence the local therapeutic effect. Implantation treatment combined with chemotherapy is an ideal measure for NSCLC treatment.