(125)I brachytherapy in the palliation of painful bone metastases from lung cancer after failure or rejection of conventional treatments

PURPOSE: This study sought to assess the safety and effect of (125)I seed implantation for palliation of painful bone metastases from lung cancer after failure or rejection of conventional treatments. MATERIALS AND METHODS: 89 patients with painful bone metastases secondary to lung cancer were consented and enrolled in this study from June 2013 to May 2015. All patients had failed or refused conventional treatments underwent percutaneous CT-guided (125)I seed implantation. The Brief Pain Inventory (BPI) was used to measure pain intensity prior to treatment (T(0)), 2, 4, 6, 8 and 12 weeks (T(2), T(4), T(6), T(8) and T(12)) after treatment in a 24-hour period. Analgesic, quality of life (QOL) scores and complications were also recorded. Four patients were excluded as they were lost to follow-up or had incomplete data. RESULTS: 85 patients with 126 bone metastases from lung cancer were treated. There were significantly lower scores after treatment in the visual analog scale (VAS) and analgesic. The VAS scores for worst pain was 6.3±1.8 at T(0). At T(2), T(4), T(6), T(8) and T(12), the score in a 24-hour period decreased to 4.9±1.2 (P<0.01), 3.7±1.3 (P<0.01), 3.4±1.2 (P<0.01), 2.6±0.9 (P<0.01), and 1.4±0.8 (P<0.01) respectively. Comparison of QOL scores showed improvements including sleep, appetite, spiritual state, and fatigue at T(2), T(4), T(6), T(8) and T(12) when compared to T(0). No serious complications or massive bleeding were observed. CONCLUSIONS: (125)I brachytherapy is a safe and effective method for palliation of painful bone metastases from lung cancer after failure or rejection of conventional treatments.