Computed tomography-guided implantation of 125I radioactive seeds in patients with malignant airway compression induced by advanced lung cancer: effectiveness and safety in 40 patients

Purpose
To evaluate the safety and efficacy of computed tomography (CT)-guided ¹²⁵I radioactive seed implantation in patients with malignant airway compression induced by advanced lung cancer.

Material and methods
Between June 2015 and June 2018, 40 patients from three medical institutions with malignant airway compression induced by advanced lung cancer were treated with ¹²⁵I seed implantation. The outcomes were measured in technical success and safety, objective response rate, complications, Karnofsky performance status (KPS) score, and survival time.

Results
All 40 patients successfully underwent implantation procedure. No procedure-associated death occurred. The most common complications were irritable cough, temporary hemoptysis, chest pain, fever, and pneumothorax, which occurred in 26 (65.0%), 31 (77.5%), 12 (30.0%), 15 (37.5%), and 11 (27.5%) patients, respectively. The objective response rates were 100%, 100%, 100%, 87.5%, and 83.3% at the 3rd, 6th, 12th, 24th, and 36th months post-procedure, respectively. The KPS score significantly improved at post-procedure. Median survival time was 25.1 months. Actuarial survival rates were 100%, 60%, and 15% at the 12th, 24th, and 36th months after the procedure, respectively.

Conclusions
For patients with malignant airway compression induced by advanced lung cancer, implantation with ¹²⁵I seed is a safe and effective alternative treatment option.