Efficacy and safety of iodine-125 radioactive seeds brachytherapy for advanced non–small cell lung cancer—A meta-analysis

Publication date: Available online 21 December 2017
Source:Brachytherapy
Author(s): Wenchao Zhang, Jiawei Li, Ran Li, Ying Zhang, Mingyong Han, Wei Ma
PURPOSEThis meta-analysis was conducted to investigate the efficacy and safety of ¹²⁵I brachytherapy for locally advanced non–small cell lung cancer (NSCLC).Methods AND MATERIALSTrials comparing ¹²⁵I brachytherapy with chemotherapy in NSCLC were identified. Meta-analysis was performed to obtain pooled risk ratios for an overall response rate (ORR), disease control rate (DCR) and complications, and pooled hazard ratio for overall survival (OS).ResultsFifteen studies including 1188 cases were included. The pooled result indicated that there were significant differences in ORR, DCR, and OS between ¹²⁵I brachytherapy combined with chemotherapy and chemotherapy alone, but no statistic differences in gastrointestinal symptoms, leukopenia, myelosuppression, and hemoglobin reduction. Patients treated with ¹²⁵I brachytherapy combined with chemotherapy have a higher relative risk of pneumothorax, bloody sputum, and pneumorrhagia compared with chemotherapy alone. Seeds migration only occurred in the group treated with ¹²⁵I brachytherapy. There were significant differences in ORR, DCR, and myelosuppression between ¹²⁵I brachytherapy alone and chemotherapy.Conclusions¹²⁵I brachytherapy combined with chemotherapy can significantly enhance the clinical efficacy and improve the OS of patients with advanced NSCLC without increasing the incidence of complications of chemotherapy. ¹²⁵I brachytherapy alone can significantly enhance the clinical efficacy and reduce the incidence of myelosuppression compared with chemotherapy. However, ¹²⁵I brachytherapy may cause lung injury. Large sample and higher-quality randomized controlled trials are needed to confirm the pooled results of complications.



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