(125)I Seed Brachytherapy Combined with Single-Agent Chemotherapy in the Treatment of Non-Small-Cell Lung Cancer in the Elderly: A Valuable Solution

PURPOSE: The aim of this study was to compare the effectiveness and safety of CT-guided (125)I seed brachytherapy combined with single-agent chemotherapy versus combined chemotherapy in the treatment of elderly NSCLC. MATERIALS AND METHODS: We retrospectively analyzed 110 patients (64 men and 46 women; mean age=71.25±7.14 years) who were diagnosed with NSCLC without distant metastases between January 2015 and May 2020. A total of 50 patients received (125)I brachytherapy combined with single-agent chemotherapy (group A), whereas 60 patients received combined chemotherapy (group B). The response to therapy and adverse effect were compared between groups. The local response rate was evaluated by CT. Progression-free survival (PFS) and overall survival (OS) data were obtained through clinical follow-up. RESULTS: All patients had been treated and were followed-up for 3–60 months. The median OS and PFS were 23.71±1.41 months (95% CI=20.95–26.47) vs 16.12±0.93 months (95% CI=14.31–17.93) (P<0.05) and 15.08±0.85 months (95% CI=13.42–16.74) vs 10.03±0.53 months (95% CI=9.01–11.06) (P<0.05) in group A and group B, respectively. The local response rate and clinical symptoms of patients in group A were significantly relieved when compared with group B. Severe complications were not observed in either group. CONCLUSION: CT-guided (125)I seed brachytherapy combined with single-agent chemotherapy is an effective and safe therapy and shows promising results compared to combined chemotherapy alone for NSCLC in the elderly. A randomized study will be needed to assess the superiority of this combined modality treatment.