Value of 125I seed implantation for patients with oligometastatic EGFR-mutant non-small cell lung cancer without progression after first-line EGFR-TKIs treatment
10.3760/cma.j.cn321828-20211213-00439
- VernacularTitle:125I粒子植入在一线EGFR－TKIs治疗后无进展的EGFR基因敏感突变寡转移非小细胞肺癌治疗中的价值
- Author:
Meng WANG
1
;
Zhigang ZHOU
;
Kepu DU
;
Shuai LI
;
Yadan LI
;
Fei GAO
;
Jianbo GAO
Author Information
1. 郑州大学第一附属医院放射科，郑州 450052
- Keywords:
Carcinoma, non-small-cell lung;
Brachytherapy;
Iodine radioisotopes;
Receptor, epidermal growth factor
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2023;43(7):402-406
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To 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. Methods:From 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. Results:The 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. Conclusion:CT-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.
