Mature Follow-Up for High-Risk Stage I Non-Small-Cell Lung Carcinoma Treated With Sublobar Resection and Intraoperative Iodine-125 Brachytherapy

Journal Article · Sat Jan 01 00:00:00 EST 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.10.030· OSTI ID:21491543

Colonias, Athanasios ^[1]; Betler, James ^[1]; Trombetta, Mark ^[1]; Bigdeli, Ghazaleh ^[2]; Gayou, Olivier ^[1]; Keenan, Robert ^[3]; Werts, E Day; Parda, David S ^[1]

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1. Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA (United States)
2. Division of Pulmonary Medicine, Allegheny General Hospital, Pittsburgh, PA (United States)
3. Drexel University College of Medicine, Allegheny Campus, Pittsburgh, PA (United States)

Purpose: To update the Allegheny General Hospital experience of high-risk Stage I non-small-cell lung cancer patients treated with sublobar resection and intraoperative {sup 125}I Vicryl mesh brachytherapy. Methods and Materials: Between January 5, 1996 and February 19, 2008, 145 patients with Stage I non-small-cell lung cancer who were not lobectomy candidates because of cardiopulmonary compromise underwent sublobar resection and placement of {sup 125}I seeds along the resection line. The {sup 125}I seeds embedded in Vicryl suture were attached with surgical clips to a sheet of Vicryl mesh, inserted over the target area, and prescribed to a 0.5-cm planar margin. Results: The mean target area, total activity, number of seeds implanted, and prescribed total dose was 33.3 cm{sup 2} (range, 18.0-100.8), 20.2 mCi (range, 11.1-29.7), 46 (range, 30-100), and 117 Gy (range, 80-180), respectively. The median length of the surgical stay was 6 days (range, 1-111), with a perioperative mortality rate of 3.4%. At a median follow-up of 38.3 months (range, 1-133), 6 patients had developed local recurrence (4.1%), 9 had developed regional failure (6.2%), and 25 had distant failure (17.2%). On multivariate analysis, no patient- or tumor-specific factors or surgical or dosimetric factors were predictive of local recurrence. The overall median survival was 30.5 months with a 3- and 5-year overall survival rate of 65% and 35%, respectively. Conclusion: {sup 125}I brachytherapy for high-risk, Stage I non-small-cell lung cancer after sublobar resection is well tolerated and associated with a low local failure rate.

• OSTI ID: 21491543
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 79, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2009.10.030; PII: S0360-3016(09)03422-1; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRACHYTHERAPY
CARCINOMAS
FAILURES
IODINE 125
LUNGS
MULTIVARIATE ANALYSIS
SURGERY
BETA DECAY RADIOISOTOPES
BODY
DAYS LIVING RADIOISOTOPES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
IODINE ISOTOPES
ISOTOPES
MATHEMATICS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPES
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
STATISTICS
THERAPY