BACKGROUNDBrachytherapy offers an innovative method of delivering conformal high-dose radiation to a defining target tumor. The aim of this study is to investigate the value and effect of using radioactivity ¹²⁵I seed permanent implants combined with chemotherapy in the management of stage III or IV lung cancer.

METHODSForty-two lung cancer patients in stage III and IV (15 center lung cancer) who couldn't be relieved by routine methods were treated with ¹²⁵I seed permanent micropuncture implant brachytherapy and chemotherapy. The dose and distribution of seeds was decided by treatment planning system, and CT was used during ¹²⁵I seed permanent implant treatment. Distribution of seeds and complication was reviewed by CT scan after treatment. Chemotherapy was performed in 3 to 7 days after implanting. The effect was observed by X-ray, CT and MRI every 3 or 4 weeks.

RESULTSThe satisfaction rate of seed distribution was 83.3% (35/42). The response rate of treatment was 85.7% (36/42), including complete response rate 26.2% (11/42), partial response rate 59.5% (25/42), no change rate 14.3% (6/42). Effective rate of pain relief was 83.3% (15/18). Thirteen patients (31.0%) had complication of mild hemothorax, 8 (19.0%) with bleeding in lung and 5 (11.9%) with hemoptysis. Three patients (7.1%) had mild pneumothorax and 1 patient (2.4%) had a malposition seed. Leucopenia and radiation pneumonia didn't occurred.

CONCLUSIONS¹²⁵I seed micropuncture implant has less trauma and complication, and is a safe and effective method. This method might be helpful in the treatment of lung cancer and can be selectively used in clinic.