1
|
Cui R, Wang XL, Cao J. Implantation of computed tomography-guided high-dose-rate 192Ir brachytherapy in oldest old patients with advanced non-small cell lung cancer: A case report and literature review. Medicine (Baltimore) 2022; 101:e32450. [PMID: 36595988 PMCID: PMC9803449 DOI: 10.1097/md.0000000000032450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND With the increasing aging and the popularization of medical diagnosis, the growing number of oldest old with lung cancer needs to be focused on. Several medical and physiological challenges often accompanying the oldest old cancer patients make the choice of the optimal treatment daunting. The current research suggests that people who get adequate treatment can benefit, but it is worth discussing which treatment will benefit them more. High-dose-rate (HDR) 192Ir brachytherapy deserves attention in this context owing to its association with less trauma and reduced complications. CASE PRESENTATION An 86-years-old woman with a right glandular lung carcinoma presented with progressive lesions 11 months after chemotherapy. Because of her old age and poor performance status (eastern cooperative oncology group performance status 3), she received HDR 192Ir brachytherapy for her right lung lesion without any common complications, such as pneumothorax and hemorrhage. She continued on 0.25 g oral gefitinib each day after received brachytherapy treatment. The right lung lesion keeps a partial response until 18 months later now. CONCLUSION HDR 192Ir brachytherapy can potentially be used as a safe and effective choice for the oldest old with advanced non-small cell lung cancer. It can especially benefit cancer patients with concurrent chemotherapy or targeted therapy.
Collapse
Affiliation(s)
- Ran Cui
- Department of Oncology, The First People’s Hospital of Neijiang, Neijiang, Sichuan, China
| | - Xiu-Lan Wang
- Department of Oncology, The First People’s Hospital of Neijiang, Neijiang, Sichuan, China
| | - Jian Cao
- Department of Oncology, The First People’s Hospital of Neijiang, Neijiang, Sichuan, China
- * Correspondence: Jian Cao, Department of Oncology, The First People’s Hospital of Neijiang, Neijiang 641000, Sichuan, China (e-mail: )
| |
Collapse
|
2
|
Jooya A, Talla K, Wei R, Huang F, Dennis K, Gaudet M. Systematic review of brachytherapy for symptom palliation. Brachytherapy 2022; 21:912-932. [PMID: 36085137 DOI: 10.1016/j.brachy.2022.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Brachytherapy is most often applied in the curative or salvage setting, but many forms of brachytherapy can be helpful for symptom palliation. Declining utilization is seen, for multiple reasons, such as lack of awareness, insufficient expertise, or poor access to equipment. High level evidence for many types of palliative brachytherapy has been lacking. The objective of the current study was to review the evidence for utilization and efficacy of brachytherapy to palliate symptoms from cancer. MATERIALS AND METHODS We performed a systematic search in EMBASE and MEDLINE for English-language articles published from January 1980 to May 2022 that described brachytherapy used for a palliative indication in adults with a diagnosis of cancer (any subtype) and at least one symptom related outcome. Individual case reports and conference abstracts were excluded. All publications were independently screened by two investigators for eligibility. RESULTS The initial search identified 3637 abstracts of which 129 were selected for in-depth review. The number of studies (total number of patients) included in the final analysis varied widely by tumor site with the majority (68.2%) involving either lung or esophageal cancer. Despite a limited number of prospective trials that assessed the efficacy of brachytherapy for symptom management, there was a positive effect on palliation of symptoms across all tumor types. There was no clear trend in the number of publications over time. The most commonly cited symptom indications for palliation by brachytherapy were dysphagia, dyspnea, pain and bleeding. CONCLUSIONS Brachytherapy can provide palliation for patients with advanced cancer, across different tumor sites and clinical scenarios. However, high level evidence in the literature to support palliative applications of brachytherapy is lacking or limited for many tumor sites. There appears to be a strong publication bias towards positive studies in favor of brachytherapy. Beyond anecdotal reports and individual practices, outcomes research can further our understanding of the role of brachytherapy in palliating advanced cancers of all types, and should be encouraged.
Collapse
Affiliation(s)
- Alborz Jooya
- Division of Radiation Oncology, The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada
| | - Kota Talla
- Division of Radiation Oncology, The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada
| | - Randy Wei
- Memorial Radiation Oncology Medical Group, Long Beach, CA
| | - Fleur Huang
- Division of Radiation Oncology, Cross Cancer Institute and University of Alberta, Edmonton, AB, Canada
| | - Kristopher Dennis
- Division of Radiation Oncology, The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada
| | - Marc Gaudet
- Division of Radiation Oncology, The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada.
| |
Collapse
|
3
|
Li X, Yin M, Xie P, Liu Y, Li X, Qi Y, Ma Y, Li C, Wu G. Self-Expandable Metallic Stent Implantation Combined With Bronchial Artery Infusion Chemoembolization in the Treatment of Lung Cancer With Complete Atelectasis. Front Oncol 2022; 11:733510. [PMID: 35096562 PMCID: PMC8790529 DOI: 10.3389/fonc.2021.733510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 12/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background Atelectasis is a common complication of lung cancer, and there are few reports about the treatment methods. This study retrospectively analyzed the safety and effectiveness of endotracheal metal stent implantation combined with arterial infusion chemoembolization in the treatment of non-small cell lung cancer with complete atelectasis. Methods The clinical data of patients with non-small cell lung cancer and complete atelectasis treated by self-expandable metallic stent implantation combined with arterial infusion chemotherapy were retrospectively analyzed. The clinical efficacy was evaluated and postoperative adverse reactions were observed. Progression-free survival and overall survival were analyzed by Kaplan-Meier method. Results In all, 42 endotracheal metallic stents were implanted in 42 patients under fluoroscopy. 5–7 days after stent implantation, CT showed that 24 patients (57.1%) had complete lung recruitment, and that 13 (31.0%) had partial lung recruitment. The technical success rate was 100%, and the clinical success rate was 88.1% (37/42). 5–7 days after stent implantation, bronchial artery infusion chemoembolization was performed in all patients. The median progression-free survival and overall survival were 6 months (95% CI: 2.04-9.66) and 10 months (95% CI: 7.22-12.79), respectively. Conclusion Self-expandable metallic stent implantation combined with arterial infusion chemoembolization may be an effective and safe strategy in the treatment of lung cancer with atelectasis clinically.
Collapse
Affiliation(s)
- Xiaobing Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Meipan Yin
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Pengfei Xie
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Liu
- Department of Respiratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiangnan Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yu Qi
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yaozhen Ma
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chunxia Li
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Gang Wu
- Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
4
|
Biciuşcă V, Popescu IAS, Traşcă DM, Olteanu1 M, Stan IS, Durand P, Camen GC, Bălteanu MA, Cazacu IM, Demetrian AD, Streba CT, Călăraşu C, Cioboată R, Cioboată R. Diagnosis of lung cancer by flexible fiberoptic bronchoscopy: a descriptive study. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2022; 63:369-381. [PMID: 36374142 PMCID: PMC9804073 DOI: 10.47162/rjme.63.2.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Flexible fiberoptic bronchoscopy (FFB) remains the most important minimally invasive method for the diagnosis of lung cancer (LC). We performed a retrospective study to assess the main endoscopic findings of malignant lung tumors in the large airways in a cohort of Romanian patients. The group consisted of 32 (84.21%) men and six (15.78%) women, with an average age of 64.63±6.07 years. The bronchoscopic examination allowed the detection and biopsy of 36 malignant lung tumors, and in two other cases, due to malignant atelectasis, the patients were sent to a Department of Thoracic Surgery, to perform the biopsy following the surgery. Histopathological (HP) examination revealed the presence of squamous cell carcinoma (SCC) in 19 (50%) patients, adenocarcinoma (ADC) in 11 (28.94%) patients and small cell lung cancer (SCLC) in eight (21.05%) patients. The macroscopic and microscopic analysis of the lung tumors showed that infiltrative forms were found in most cases (58.33%), followed by exophytic (mass) endobronchial lesions (22.22%) and mixed forms (19.44%). If most infiltrative forms were SCC (66.66%), the exophytic and mixed lesions were most frequently ADC (50% and 57.14%). The tumor lesions caused both malignant bronchial stenosis (57.89%) and malignant atelectasis (42.1%). The main mechanisms involved in bronchial malignant obstruction were endoluminal (50%), mixed (31.57%) and extraluminal (18.42%) mechanisms. In conclusion, FFB remains the main method of diagnosing LC in the large airways. The most common macroscopic appearance of lung tumors revealed by bronchoscopy was the infiltrative appearance. In half of our patients, the malignant bronchial obstruction was achieved by endoluminal mechanism. The most common pathological form found in our patients was the SCC, as described in half of the investigated patients.
Collapse
Affiliation(s)
- Viorel Biciuşcă
- Department of Internal Medicine, Department of Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania; ;
| | - Iulian Alin Silviu Popescu
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Diana Maria Traşcă
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Mihai Olteanu1
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Ionelia Sorina Stan
- Resident Physician, Department of Internal Medicine, Emergency County Hospital, Craiova, Romania
| | - Patricia Durand
- Resident Physician, Department of Internal Medicine, Filantropia Municipal Hospital, Craiova, Romania
| | - Georgiana-Cristiana Camen
- Department of Radiology and Medical Imaging, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Mara Amalia Bălteanu
- Department of Pneumology, Faculty of Medicine, Titu Maiorescu University, Romania
| | - Irina Mihaela Cazacu
- Department of Oncology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Alin Dragoş Demetrian
- Department of Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Costin Teodor Streba
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Cristina Călăraşu
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Ramona Cioboată
- Department of Internal Medicine, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Computed tomography-guided implantation of 125I radioactive seeds in patients with malignant airway compression induced by advanced lung cancer: effectiveness and safety in 40 patients. J Contemp Brachytherapy 2020; 12:343-350. [PMID: 33293973 PMCID: PMC7690234 DOI: 10.5114/jcb.2020.98113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/03/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose To evaluate the safety and efficacy of computed tomography (CT)-guided 125I radioactive seed implantation in patients with malignant airway compression induced by advanced lung cancer. Material and methods Between June 2015 and June 2018, 40 patients from three medical institutions with malignant airway compression induced by advanced lung cancer were treated with 125I seed implantation. The outcomes were measured in technical success and safety, objective response rate, complications, Karnofsky performance status (KPS) score, and survival time. Results All 40 patients successfully underwent implantation procedure. No procedure-associated death occurred. The most common complications were irritable cough, temporary hemoptysis, chest pain, fever, and pneumothorax, which occurred in 26 (65.0%), 31 (77.5%), 12 (30.0%), 15 (37.5%), and 11 (27.5%) patients, respectively. The objective response rates were 100%, 100%, 100%, 87.5%, and 83.3% at the 3rd, 6th, 12th, 24th, and 36th months post-procedure, respectively. The KPS score significantly improved at post-procedure. Median survival time was 25.1 months. Actuarial survival rates were 100%, 60%, and 15% at the 12th, 24th, and 36th months after the procedure, respectively. Conclusions For patients with malignant airway compression induced by advanced lung cancer, implantation with 125I seed is a safe and effective alternative treatment option.
Collapse
|
6
|
Yang DY, Lin YP, Xue C, Fan JM, Wang Y, Cai C, Song DH, Zeng YM. CT-guided percutaneous implantation of 125I particles in treatment of early lung cancer. J Thorac Dis 2020; 12:5996-6009. [PMID: 33209432 PMCID: PMC7656391 DOI: 10.21037/jtd-20-2666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Background To analyze the efficacy of computed tomography (CT)-guided implantation of 125I radioactive particles in treatment of early lung cancer. Methods Six patients were analyzed, including 4 squamous cell carcinoma, 1 adenocarcinoma, and 1 small cell lung cancer. TPS software was used to calculate the therapeutic dose amount of particles implanted, and the spacing and distribution of seeds in the target area and adjacent tissues. Under the guidance of CT, 20–55 particles were implanted at each site, with the total number of radioactive particles being 226, the particle spacing being 0.5–1.0 cm, and the implantation being performed in accordance with the principle of uniform implantation. The patients were each followed up with repeated pulmonary CT scans at 1, 3, 6, 12, 18, 24, 30 and 36 months after the procedure. In accordance with the response evaluation criteria in solid tumors (RECIST), the following definitions for responses were used: complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD). Results There were 2 CRs and 4 PRs one month after procedure; six patients were followed up 3 months after procedure, including 2 CRs and 4 PRs; one patient was lost in follow-up, and 5 patients were followed up 6 months after procedure, including 3 CRs and 2 PRs; five patients were followed up 12 months after procedure, including 3 CRs, 1 PR and 1 PD. The single PD patient was again given CT-guided implantation of 125I radioactive particles for the treatment of recurrent lesions. The pulmonary CT was repeated 6 months after procedure, and the response was evaluated as SD. Four patients were followed up 18 months after procedure, including 3 CRs and 1 PR; one patient was lost in follow-up and 3 patients were followed up 24 months after the procedure with the response being evaluated as CR for all of them; one patient was followed up 36 months after procedure, and the response was evaluated as PD. During the follow-up, no serious complications occurred in any of the patients. Conclusions The preliminary clinical observation showed that 125I radioactive particle implantation was a safe, reliable and effective therapeutic method for early lung cancer.
Collapse
Affiliation(s)
- Dong-Yong Yang
- Respiratory Medicine Center of Fujian Province, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yan-Ping Lin
- Intensive Care Unit, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Cheng Xue
- Respiratory Medicine Center of Fujian Province, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Ji-Min Fan
- Respiratory Medicine Center of Fujian Province, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yi Wang
- CT Examination Room, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Chi Cai
- CT Examination Room, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Duan-Hong Song
- Respiratory Medicine Center of Fujian Province, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yi-Ming Zeng
- Respiratory Medicine Center of Fujian Province, Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| |
Collapse
|
7
|
Implantation of 125I radioactive seeds via c-TBNA combined with chemotherapy in an advanced non-small-cell lung carcinoma patient. BMC Pulm Med 2019; 19:205. [PMID: 31703663 PMCID: PMC6842247 DOI: 10.1186/s12890-019-0974-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 10/28/2019] [Indexed: 01/03/2023] Open
Abstract
Background The critical management of advanced non-small-cell lung carcinoma (NSCLC), especially when complicated by severe airway stenosis, is difficult and often leads to high clinical risks and medical costs. Case presentation A 51-year-old previously healthy male was admitted to the Department of Respiratory and Critical Care Medicine, Taizhou People’s Hospital, in November 2018 for haemoptysis and difficulty breathing during a 15-d period. Following admission, chest computed tomography (CT) showed a large mass in the left hilum with atelectasis in the left upper lobe and obstructive pneumonia in the left lower lobe. Bronchoscopy revealed that the lesions occurred in the distal segment of the left main trachea, with occlusion of the left upper bronchus and significant narrowing of the lower bronchus. A basal mucosal biopsy of the lump tissue was performed after haemostasis treatment with sub-plasma coagulation (APC), and squamous lung carcinoma was confirmed. Following the final diagnosis, the patient was successfully treated with implantation of 125I radioactive seeds via transbronchial needle aspiration (c-TBNA) combined with chemotherapy. Conclusion We believe that implantation of 125I radioactive seeds via c-TBNA is an effective treatment for patients with advanced lung cancer and those presenting with severe and mixed main bronchus stenosis.
Collapse
|
8
|
Zhang F, Wang J, Guo J, Li Y, Huang X, Guan Z, Lei G, Wang J, Ye X, Zhao X, Wang J, Wang R, Liu B. Chinese Expert Consensus Workshop Report: Guideline for permanent iodine-125 seed implantation of primary and metastatic lung tumors. Thorac Cancer 2019; 10:388-394. [PMID: 30521144 PMCID: PMC6360234 DOI: 10.1111/1759-7714.12912] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/11/2018] [Indexed: 12/20/2022] Open
Abstract
Surgery remains the first choice of cure for early stage lung cancer. However, many patients are diagnosed at advanced stage, and thus miss the opportunity to undergo surgery. As such patients derive limited benefits from chemotherapy or radiotherapy, alternatives focusing on local control have emerged, including iodine-125 seed implantation. The Interstitial Brachytherapy Society, Committee of Minimally Invasive Therapy in Oncology, Chinese Anti-Cancer Association organized a group of multidisciplinary experts to develop guidelines for this treatment modality. These guidelines aim to standardize iodine-125 seed implantation procedures, inclusion criteria, and outcome assessment to prevent and manage procedure-related complications.
Collapse
Affiliation(s)
- Fujun Zhang
- Imaging and Interventional CenterSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Junjie Wang
- Department of Radiation Oncology, Cancer CentrePeking University Third HospitalBeijingChina
| | - Jinhe Guo
- Department of RadiologySoutheast University, Zhongda HospitalNanjingChina
| | - Yuliang Li
- Department of Interventional MedicineThe Second Hospital of Shandong UniversityJinanChina
- Interventional Oncology Institute of Shandong UniversityJinanChina
| | - Xuequan Huang
- Department of Interventional MedicineThe First Hospital Affiliated to AMU (Southeast Hospital)ChongqingChina
| | - Zhiyu Guan
- Department of Thoracic SurgeryThe Second Hospital of Tianjin Medical UniversityTianjinChina
| | - Guangyan Lei
- Department of Thoracic SurgeryShaanxi Provincial Cancer HospitalXi'anChina
| | - Juan Wang
- Department of OncologyHebei General HospitalShijiazhuangChina
| | - Xin Ye
- Department of OncologyShandong Provincial Hospital Affiliated to Shandong UniversityJinanChina
| | - Xiaogang Zhao
- Department of Thoracic SurgeryThe Second Hospital of Shandong UniversityJinanChina
| | - Jing Wang
- Department of RespirationShandong Provincial Hospital Affiliated to Shandong UniversityJinanChina
| | - Ruoyu Wang
- Department of OncologyThe Affiliated Zhongshan Hospital of Dalian UniversityDalianChina
| | - Bin Liu
- Department of Interventional MedicineThe Second Hospital of Shandong UniversityJinanChina
- Interventional Oncology Institute of Shandong UniversityJinanChina
| |
Collapse
|
9
|
Ma X, Yang PZ, Jiang PS, Huo PB, Cao Q, Chai PS, Wang PH. Effectiveness and safety of a robot-assisted 3D personalized template in 125I seed brachytherapy of thoracoabdominal tumors. J Contemp Brachytherapy 2018; 10:368-379. [PMID: 30237820 PMCID: PMC6142644 DOI: 10.5114/jcb.2018.77957] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/10/2018] [Indexed: 12/27/2022] Open
Abstract
PURPOSE This research aims to evaluate the effectiveness and safety of a robot-assisted 3D personalized template in 125I seed brachytherapy of thoracoabdominal tumors. MATERIAL AND METHODS Forty-three patients with different tumors were involved in this research between 2013 and 2015. They were all eligible to 125I seed implantation based on robot-assisted 3D personalized template. Meanwhile, 51 patients with similar tumors, which were treated with a conventional coplanar template, were involved for comparison. Follow-up was carried out after the surgery to evaluate the therapeutic efficacy, including overall survival (OS) of the patient and local control (LC) of the tumor. Complications were also summarized to evaluate the safety. Besides, statistical analysis was achieved to investigate possible factors associated with the result. RESULTS In the robot-assisted 3D personalized template-guided brachytherapy, the median target volume treated by the prescription dose (V100) was 95.3% (range, 92.4-109.8), and the median dose administered to 90% of the target volume (D90) was 126.1 Gy (range, 114.2-132.0), improved 5% and 8% compared with the conventional template-guided brachytherapy, respectively. The median OS was 30 months (95% CI: 19.4-40.6) and the rates of 2-year OS and LC were 58.1% and 86.0%, respectively. The median OS was prolonged 10 months and the 2-year OS and LC were improved 18.9% and 23.3% compared with the conventional template-guided brachytherapy, respectively. CONCLUSIONS Through analysis of the selected patients with thoracoabdominal tumors, the robot-assisted 3D personalized template in 125I seed brachytherapy was a more effective and safer method. It can achieve a more favorable OS and LC.
Collapse
Affiliation(s)
- Xiaodong Ma
- School of Mechanical Engineering, Tianjin University, Tianjin
| | | | | | - Prof. Bin Huo
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qiang Cao
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Prof. Shude Chai
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Prof. Haitao Wang
- Department of Oncology, the Second Hospital of Tianjin Medical University, Tianjin, China
| |
Collapse
|
10
|
Zhang W, Li J, Li R, Zhang Y, Han M, Ma W. Efficacy and safety of iodine-125 radioactive seeds brachytherapy for advanced non–small cell lung cancer—A meta-analysis. Brachytherapy 2018; 17:439-448. [DOI: 10.1016/j.brachy.2017.11.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 11/23/2017] [Accepted: 11/24/2017] [Indexed: 12/18/2022]
|
11
|
Lu M, Yao W, Zhang T, Fan W, Zhong Z, Li J, Zhang F. Feasibility and Efficacy of Microwave Ablation Combined with Iodine-125 Seed Implantation in Local Control of Recurrent Retroperitoneal Liposarcomas: Initial Clinical Experience. Oncologist 2017; 22:1500-1505. [PMID: 28701568 PMCID: PMC5728019 DOI: 10.1634/theoncologist.2016-0499] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 04/11/2017] [Indexed: 12/16/2022] Open
Abstract
Surgical resection is the primary treatment option for retroperitoneal liposarcomas, but complete resection is difficult and postoperative recurrence and metastasis are common. This prospective study analyzed the feasibility and efficacy of microwave ablation combined with iodine‐125 seed implantation in the local control of recurrent retroperitoneal liposarcomas. Introduction. The objective of the present study was to evaluate the feasibility, safety, and short‐term efficacy of microwave ablation (MWA) combined with iodine‐125 (125I) seed implantation in recurrent retroperitoneal liposarcomas (rRPLs). Materials and Methods. From September 2012 to March 2015, 11 patients were enrolled in this prospective study. Eleven tumors (median, 9 cm; range, 5.5–12.5 cm) were treated with computerized tomography‐guided MWA for 11 sessions and 125I seed implantation for 18 sessions. 125I seed implantation was performed 4 weeks after MWA. Results. There were no procedure‐related deaths. Post‐MWA pain (grade ≥2) was the most common complication (6 of 11 patients, 54.5%), and fever (grade ≥2) was observed in two patients. Reversible nerve injury, defined as transient limb paresthesia or leg weakness, was observed in one patient. There were fewer complications associated with the 125I seed implantation procedure compared with the MWA procedure. All 11 patients who underwent the MWA procedure achieved a partial response (PR), according to the modified Response Evaluation Criteria in Solid Tumors, 1 month post‐ablation; after 125I seed implantation was performed, a complete response was observed in three, five, and six target tumors in 3, 6, and 12 months, respectively. Conclusion. In selected patients with rRPLs, MWA combined with 125I seed implantation is feasible and safe with favorable local control efficacy. Implications for Practice. This study evaluated the feasibility, safety, and short‐term efficacy of microwave ablation (MWA) combined with iodine‐125 (125I) seed implantation in recurrent retroperitoneal liposarcomas (rRPLs). Results suggest that a single session of MWA may be not sufficient in large‐volume rRPLs and that as a supplement treatment, 125I seed implantation is safe and easy accessible. MWA combined with 125I seed has excellent local control effectiveness, and long‐term efficacy and survival benefit still need to be more comprehensively evaluated.
Collapse
Affiliation(s)
- Mingjian Lu
- Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Wang Yao
- Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Tao Zhang
- Department of Medical Imaging & Interventional Radiology, Guangzhou Women and Children's Medical Center, Guangzhou, P.R. China
| | - Wenzhe Fan
- Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Zhihui Zhong
- Department of Medical Imaging & Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, P.R. China
| | - Jiaping Li
- Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China
| | - Fujun Zhang
- Department of Medical Imaging & Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, P.R. China
| |
Collapse
|
12
|
Guy CL, Weiss E, Jan N, Reshko LB, Christensen GE, Hugo GD. Effect of atelectasis changes on tissue mass and dose during lung radiotherapy. Med Phys 2017; 43:6109. [PMID: 27806593 PMCID: PMC5085974 DOI: 10.1118/1.4965807] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose: To characterize mass and density changes of lung parenchyma in
non-small cell lung
cancer
(NSCLC)
patients following midtreatment resolution of atelectasis and to quantify the
impact this large geometric change has on normal tissue
dose. Methods: Baseline and midtreatment CT
images and contours were obtained for 18 NSCLC patients with
atelectasis. Patients were classified based on atelectasis volume reduction
between the two scans as having either full, partial, or no resolution. Relative
mass and density changes from baseline to midtreatment were calculated based on
voxel intensity and volume for each lung lobe. Patients also had clinical treatment
plans available which were used to assess changes in normal tissue
dose
constraints from baseline to midtreatment. The midtreatment image was
rigidly aligned with the baseline scan in two ways: (1) bony anatomy and (2)
carina. Treatment parameters (beam apertures, weights, angles, monitor units,
etc.) were transferred to each image. Then, dose was recalculated.
Typical IMRT dose constraints were evaluated on all images, and the
changes from baseline to each midtreatment image were
investigated. Results: Atelectatic lobes experienced mean (stdev) mass changes of −2.8% (36.6%), −24.4%
(33.0%), and −9.2% (17.5%) and density changes of −66.0% (6.4%), −25.6% (13.6%),
and −17.0% (21.1%) for full, partial, and no resolution, respectively. Means
(stdev) of dose changes to spinal cord Dmax,
esophagus Dmean, and lungs
Dmean were 0.67 (2.99), 0.99 (2.69), and 0.50 Gy (2.05
Gy), respectively, for bone alignment and 0.14 (1.80), 0.77 (2.95), and 0.06 Gy
(1.71 Gy) for carina alignment. Dose increases with bone alignment up to 10.93,
7.92, and 5.69 Gy were found for maximum spinal cord, mean esophagus, and mean
lung
doses,
respectively, with carina alignment yielding similar values. 44% and 22% of
patients had at least one metric change by at least 5 Gy (dose metrics) or 5%
(volume metrics) for bone and carina alignments, respectively. Investigation of
GTV coverage showed mean (stdev) changes in VRx,
Dmax, and Dmin of −5.5%
(13.5%), 2.5% (4.2%), and 0.8% (8.9%), respectively, for bone alignment with
similar results for carina alignment. Conclusions: Resolution of atelectasis caused mass and density decreases, on average, and
introduced substantial changes in normal tissue
dose
metrics in a subset of the patient cohort.
Collapse
Affiliation(s)
- Christopher L Guy
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298
| | - Elisabeth Weiss
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298
| | - Nuzhat Jan
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298
| | - Leonid B Reshko
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298
| | - Gary E Christensen
- Department of Electrical and Computer Engineering and Department of Radiation Oncology, University of Iowa, Iowa City, Iowa 52242
| | - Geoffrey D Hugo
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298
| |
Collapse
|
13
|
Huo X, Wang H, Yang J, Li X, Yan W, Huo B, Zheng G, Chai S, Wang J, Guan Z, Yu Z. Effectiveness and safety of CT-guided 125I seed brachytherapy for postoperative locoregional recurrence in patients with non–small cell lung cancer. Brachytherapy 2016; 15:370-380. [DOI: 10.1016/j.brachy.2016.02.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 01/22/2016] [Accepted: 02/02/2016] [Indexed: 10/22/2022]
|