(125)I seed brachytherapy versus external beam radiation therapy for the palliation of painful bone metastases of lung cancer after one cycle of chemotherapy progression

PURPOSE: This study aimed to compare the outcomes of (125)I seed brachytherapy versus external beam radiation therapy (EBRT) for the palliation of painful bone metastases of lung cancer after one cycle of chemotherapy progression. MATERIALS AND METHODS: We analyzed retrospectively 158 patients with painful bone metastases secondary to lung cancer after one cycle of chemotherapy progression treated between June 2013 and May 2016. Seventy-six patients with 96 lesions received (125)I brachytherapy (Group A), whereas 82 patients with 98 metastases received EBRT (Group B). Pain intensity on Brief Pain Inventory, percentage of patients with pain severity, and quality of life were recorded prior to treatment (T(0)), 2, 4, 6, 8, 12, 16, 20, and 24 weeks (T(2), T(4), T(6), T(8), T(12), T(16), T(20), and T(24)) after treatment during a 24-hour period. Cost-effectiveness and number of treatment appointments were also compared between groups. RESULTS: One hundred and fifty-eight patients had been treated. Visual analog scale for worst pain in Group A was significantly lower than in Group B at T(2), T(4), T(6), T(16), T(20), and T(24). Group A was superior to group B concerning quality of life scores (T(2), T(4), T(20), and T(24)), cost-effectiveness, and number of treatment appointments. No significant differences were observed for complications. CONCLUSION: Compared with EBRT, (125)I seed brachytherapy can be an alternative method for painful bone metastases from lung cancer after one cycle of chemotherapy progression.