Study of percutaneous ^125I seeds implantation guided by CT in elderly patients of stage I peripheral non-small cell lung cancer

Objective To evaluate the efficacy, feasibility and safety of CT guided percutaneous 1251 seeds implantation in elderly patients of stage Ⅰ peripheral non-small cell lung cancer （ NSCLC ）. Methods Clinical data of 16 elderly peripheral stage I NSCLC patients （ 10 squamous carcinoma and 6 adenocareinoma;13 stage ⅠA and 3 stage ⅠB） who received radioactive ^125I seeds implantation because of refusal or being unsuited to operation or external radiotherapy were retrospectively analyzed. Prescribed dose was 140 -160 Gy. Under CT guidance, ^125I seeds were implanted pereutaneously into tumors for interstitial radiotherapy according to treatment plan system. Results Mean number of ^125I seeds each patient received was 21.1. 12 complete response （CR） and 4 partial response （PR） were achieved. Total response rate （CR ＋ PR） was 100%. 100% patients completed 10 to 56 months of follow-up, 15, 13, 8 and 6 patients completed 1-, 2-, 3-and 4-years＇follow-up, respectively. The median local progression free time was 14 months. The 1-, 2-, 3-and 4-year overall survival rate were 60%, 54%, 50% and 33%, respectively （median： 14 months）. 7 cases died of non-tumor disease and 5 died of metastasis. No severe complications were observed. Conclusions CT guided ^125I seeds implantation is a safe, reliable and effective radical treatment method for elderly stage I peripheral NSCLC patients, who refuse to or are unsuitable to operation or external radiotherapy. Key words: Carcinoma, non-small cell lung/radiotherapy;  Radiotherapy, ^125I seeds implantation;  Elderly patients;  Stage Ⅰ peripheral