AUTHOR=Wang Hao , Lu Jian , Zheng Xiao-Ting , Zha Jun-Hao , Jing Wen-Dong , Wang Yong , Zhu Guang-Yu , Zeng Chu-Hui , Chen Lei , Guo Jin-He 

TITLE=Oligorecurrence Non–small Cell Lung Cancer After Failure of First-Line Chemotherapy: Computed Tomography–Guided 125I Seed Implantation vs. Second-Line Chemotherapy

JOURNAL=Frontiers in Oncology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.00470

DOI=10.3389/fonc.2020.00470

ISSN=2234-943X

ABSTRACT=<p><bold>Purpose:</bold> To compare the efficacy and safety of computed tomography (CT)–guided <sup>125</sup>I seed implantation with second-line chemotherapy in treatment of oligorecurrence non–small cell lung cancer after failure of first-line chemotherapy.</p><p><bold>Methods:</bold> Data of oligorecurrence non–small cell lung cancer patients after failure of first-line chemotherapy at two institutions were retrospectively reviewed from January 2013 to July 2018. A total of 53 patients who received the treatment of <sup>125</sup>I seed implantation or second-line chemotherapy were eligible for this study. In group A, 25 patients, 84 lesions, received CT-guided permanent <sup>125</sup>I seed implantation, whereas in group B, 28 patients, 96 lesions, received second-line chemotherapy. The outcomes were measured in terms of disease control rate, overall survival, quality of life, and complications.</p><p><bold>Results:</bold> The median follow-up period was 13 months (range, 5–42 months). Disease control rate in group A was higher than that in group B (70.8 vs. 42.3%, <italic>P</italic> = 0.042) at 6 months after treatment. The median overall survival was 12.8 months (95% confidence interval, 10.5–15.1 months) in group A and 15.2 months (95% confidence interval, 12.2–18.2 months) in group B, with no significant difference (<italic>P</italic> = 0.847). Since the fourth month, the number of patients in group A with a non-decreasing Karnofsky Performance Scale score was more than that in group B (<italic>P</italic> &lt; 0.05). The incidence of grade 3 or higher complications especially hematologic toxicity in group A was significantly lower than that in group B (<italic>P</italic> &lt; 0.05).</p><p><bold>Conclusion:</bold> Radioactive <sup>125</sup>I seed implantation is safe and feasible in selected non–small cell lung cancer patients with oligorecurrence after failure of first-line chemotherapy and seems to provide a better long-term quality of life in these patients compared with second-line chemotherapy.</p>