Résumé
Objective:To evaluate the clinical efficacy and adverse events of 192Ir high-dose rate brachytherapy (HDR-BT) in the treatment of locally recurrent non-small cell lung cancer (NSCLC). Methods:Clinical data of 22 cases of recurrent NSCLC after radiotherapy admitted to our hospital from September 2013 to March 2018 were retrospectively analyzed. 192Ir HDR-BT was adopted for reradiotherapy. The prescription dose was 30Gy for 1 fraction. CT scan was reviewed every 1 month in the first 3 months after treatment and every 3 months after 3 months. Local control rate and adverse events were evaluated. The 1-and 2-year overall survival (OS) rates of re-treatment after relapse were calculated. Results:All the 22 patients completed the treatment successfully. The 1-, 3-and 6-month complete response (CR) rates were 9%, 14% and 14%, 82%, 82% and 82% for the partial response (PR) rates, 5%, 0% and 0% for the stable disease (SD) rates, 5%, 5% and 5% for the progressive disease (PD) rates, 91%, 96% and 96% for the objective response rates (ORR), respectively. The 1-and 2-year OS rates of re-treatment after relapse were 59% and 27%. Five patients (23%) experienced acute radiation-induced pneumonitis (3 cases of grade 1 and 2 cases of grade Ⅱ), 4 cases (18%) of radiation-induced bone marrow suppression (3 cases of grade I leukopenia and 1 case of grade I thrombocytopenia) and 1 case of postoperative pneumothorax. All these adverse events were mitigated after symptomatic treatment.Conclusion:192Ir HDR-BT is an efficacious and safe treatment of locally recurrent NSCLC.
Résumé
Objective@#To investigate the efficacy and feasibility of 192Ir high-dose rate brachytherapy for recurrent intrapulmonary oligometastasis after colorectal cancer surgery.@*Methods@#Patients from May 2013 to October 2017 with intrapulmonary oligometastasisafter colorectal cancer surgery in Cangzhou Integrated Traditional Chinese and Western Medicine Hospital were enrolled. A total of 15 lesions were obtained from 10 patients, which were treated with CT-guided high dose rate of 192Ir. The implant needles were inserted into the tumor and were adjusted to appropriate positions under the guidance of CT. Then the images after transplanting were uploaded to the planning system to delineate the target area and the organ at risk volume. Patients underwent a single radiation dose of 20 Gy.@*Results@#All 10 patients were successfully treated. Grade 1 adverse events were observed for 30% of patients. Of the 10 patients, one patient had a mild cough, and two had bloody sputum. There was no serious adverse events occurred. The local control rate (LC) of the patients at 1 year after treatment was achieved in 93.3%. Only one developed local advancement after six months, who received the secondary brachytherapy. The median progression-free survival(PFS) was 8.5 months and the median overall survival(OS) was 14.7 months.@*Conclusions@#High dose rate brachytherapy is effective in terms of recurrent lung metastases after surgery for colorectal cancer, with a moderate rate of adverse reactions and a favorable local tumor control rate.