Efficacy and Safety of <sup>125</sup>I Seed Interstitial Implantation for Lung Cancer: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 ZENGLin-miao ¹ , YUXiao-lian ² , YUTing-ting ³ , XIAOJian-hong ¹ , SONGBin ¹ ,  PENGJin-yun ¹

1. Mindong Hospital Affiliated to Fujian Medical University, Fu'an 355000, China;
2. Fujian Mindong Health School, Fu'an 355017, China;
3. Fujian Vocational College Of Bioengineering, Fuzhou 350002, China;

Corresponding?author：

PENGJin-yun, Email: 569972281@qq.com

Keywords：

¹²⁵I radioactive seed; Implantation; Brachytherapy; Lung cancer; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20150160

Video：

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Objective To systematically evaluate the efficacy and safety of ¹²⁵I seed interstitial implantation for lung cancer. Methods We searched PubMed, The Wiley Online Library, Elsevier, CNKI, VIP and WanFang Data from inception to February 2014 to collect randomized controlled trials (RCTs) of ¹²⁵I seed interstitial implantation in the treatment of lung cancer. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies, and then meta-analysis was performed by using RevMan 5.1 software. Results A total of 23 RCTs involving 1 492 patients were included. The results of meta-analysis showed that:the effective rate (OR=3.43,95%CI 2.71,4.33,P<0.000 01), 1 year survival rate (OR=2.83, 95%CI 2.03 to 3.95, P<0.000 01) and 2 year survival rate (OR=2.49, 95%CI 1.60 to 3.88, P<0.000 01) in the ¹²⁵I seed interstitial implantation group were higher than those in the control group, but the rate of postoperative complications was higher than that of control group (OR=19.72, 95%CI 11.63 to 33.45, P<0.000 01). In addition, there were no significant differences between both groups in the 3 year survival rate (OR=2.45, 95%CI 0.21 to 28.89, P=0.48) and the adverse reaction rate (OR=0.74, 95%CI 0.52 to 1.05, P=0.09). Conclusion ¹²⁵I seed interstitial implantation is effective in the treatment of lung cancer. It can improve treatment efficiency and short-time survival rate, but may increase the rate of complications such as pneumothorax, seed malposition, bleeding and so on. Due to the limited quality and quantity of included studies, more high quality and larger sample studies are needed to verify the above conclusion.

Citation： ZENGLin-miao, YUXiao-lian, YUTing-ting, XIAOJian-hong, SONGBin, PENGJin-yun. Efficacy and Safety of ¹²⁵I Seed Interstitial Implantation for Lung Cancer: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(8): 957-966. doi: 10.7507/1672-2531.20150160 Copy

1.	Torres M, Carvalho A, Riera R. Non-invasive positive pressure ventilation for prevention of complications after pulmonary resection in lung cancer patients. Cochrane Database Syst Rev, DOI:10.1002/14651858.CD010355.
2.	Ettinger DS, Akerley W, Borghaei H, et al. Non-small cell lung cancer. J Natl Compr Canc Netw, 2012, 10(10):1236-1271.
3.	過為, 李健華, 王峰, 等. 奈達鉑聯合化療治療晚期非小細胞肺癌療效和安全性的Meta分析. 中國循證醫學雜志, 2013, 13(1):47-54.
4.	Ettinger DS, Akerley W, Borghaei H, et al. Non-small cell lung cancer, version 2.2013. J Natl Compr Canc Netw, 2013, 11(6):645-653.
5.	Solano-Reina S, De Granda-Orive Ji, Jiménez-Ruiz CA. Smoking cessation:an essential component in the treatment of lung cancer patients. Arch Bronconeumol, 2011, 47(9):477.
6.	Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin, 2009, 59(4):225-249.
7.	王忠敏, 黃鋼, 陳克敏, 等. 放射性粒子組織間植入治療技術指南的建議. 介入放射學雜志, 2009, 18(9):641-644.
8.	Martínez-Monge R, Pagola M, Vivas I, et al. CT-guided permanent brachytherapy for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC). Lung Cancer, 2008, 61(2):209-213.
9.	晏欣珺, 鄭長福, 嚴厚君, 等. ¹²⁵I粒子植入聯合GP方案治療局部晚期非小細胞肺癌33例療效評價. 腫瘤學雜志, 2013, 19(5):408-410.
10.	Higgins J, Green S. Cochrane Handbook for Systematic Review of interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochranehand-book.org.
11.	叢云峰. 放射性¹²⁵I粒子植入治療中晚期肺癌惡性管腔狹窄32例臨床效果探討. 中外健康文摘, 2013, 10(5):102.
12.	郭國華. ¹²⁵I放射性粒子肺內插植聯合吉西他濱+順鉑支氣管動脈灌注化療治療中晚期非小細胞肺癌臨床療效觀察. 中國現代醫生, 2012, 50(32):152-153.
13.	郭志遠, 崔建嶺, 付呂平, 等. ¹²⁵I放射性粒子組織間植入聯合化療治療非小細胞肺癌的研究. 河北醫藥, 2011, 33(8):1134-1137.
14.	賀克武, 高斌, 秦漢林, 等. ¹²⁵I粒子組織間植入聯合支氣管動脈灌注化療治療肺癌的療效觀察. 介入放射學雜志, 2012, 21(7):554-558.
15.	林鋒, 冉鵬, 肖家榮, 等. 術中植入放射性¹²⁵I粒子治療肺癌效果分析. 廣東醫學, 2010, 31(1):104-106.
16.	陸相楊, 王啟飛. ¹²⁵I粒子姑息治療ⅢB期非小細胞肺癌的近期療效觀察. 寧夏醫科大學學報, 2011, 33(6):551-553.
17.	駱紅蕾, 喻曉娟, 李進, 等. ¹²⁵I粒子植入聯合化療治療同期放化療后局部復發的Ⅲ期非小細胞肺癌. 中華核醫學與分子影像雜志, 2013, 33(3):195-198.
18.	鐘輝. CT引導下¹²⁵I粒子植入治療肺癌的價值探討. 健康必讀(下旬刊), 2011, 5:129.
19.	時沛. ¹²⁵I粒子植入聯合NP方案化療治療晚期非小細胞肺癌的臨床研究. 中國誤診學雜志, 2010, 10(1):39-40.
20.	宋愛國, 劉增良, 楊秀貞, 等. 放射性¹²⁵I粒子植入治療局部晚期肺癌的近期療效. 河北醫藥, 2012, 34(6):844-845.
21.	晏欣珺, 鄭長福, 嚴厚君, 等. ¹²⁵I粒子植入聯合GP方案治療局部晚期非小細胞肺癌33例療效評價. 腫瘤學雜志, 2013, 19(5):408-410.
22.	楊樹法, 樊喜文, 張國慶, 等. 放射性¹²⁵I粒子植入聯合化療治療不可手術的局部晚期非小細胞肺癌的療效和安全性. 中華腫瘤雜志, 2010, 32(8):626-629.
23.	趙書元. ¹²⁵I粒子植入聯合支氣管動脈灌注化療治療中晚期肺癌的臨床研究. 中國醫藥指南, 2013, 11(25):87-88.
24.	鄭琳, 郭晨陽, 黎海亮. 吉西他濱、順鉑雙路徑用藥聯合¹²⁵I粒子植入治療Ⅲ期非小細胞肺癌的臨床對照研究. 中華放射學雜志, 2011, 45(4):379-382.
25.	李俊升, 李建華, 王昕, 等. ¹²⁵I放射性粒子術中組織間植入治療Ⅲa期非小細胞肺癌的近期臨床研究. 內蒙古醫學雜志, 2005, 37(4):303-304.
26.	杜學明, 許建輝, 郎建華, 等. ¹²⁵I粒子聯合化療治療非小細胞肺癌. 腫瘤, 2007, 27(5):406-408.
27.	李玉亮, 王永正, 張福君, 等. CT引導下經皮穿刺植入¹²⁵I粒子治療老年中心型肺癌近期療效分析. 中華腫瘤防治雜志, 2007, 14(23):1818-1820.
28.	劉春香, 劉濤, 李德杰, 等. 經支氣管動脈化療藥物灌注術聯合¹²⁵I粒子植入治療老年中心型肺癌近期療效分析. 中華腫瘤防治雜志, 2007, 14(12):951-952.
29.	田立景, 田秀榮. ¹²⁵I粒子內放療聯合化療治療中晚期肺癌52例療效分析. 中國腫瘤臨床, 2008, 35(2):82-84.
30.	王馨, 吳煒新, 王衛星, 等. ¹²⁵I粒子腫瘤內植入聯合吉西他濱治療周圍性非小細胞肺癌. 介入放射學雜志, 2008, 17(3):194-196.
31.	趙化云. 中醫藥聯合¹²⁵I植入對老年中晚期非小細胞肺癌生存質量的臨床觀察. 河南中醫學院, 2008.
32.	張青平, 趙志勇, 林武華, 等. CT導向下¹²⁵I粒子組織間植入治療局部晚期非小細胞肺癌臨床研究(附56例報告). 腫瘤預防與治療, 2009, 22(4):392-394.
33.	胡永進, 杜學明, 吳春娃, 等. ¹²⁵I粒子植入聯合化療對小細胞肺癌生存期的影響. 武警后勤學院學報(醫學版), 2013, 22(7):602-605.
34.	裘海燕, 許飛, 張偉, 等. ¹²⁵I粒子植入聯合化療治療晚期非小細胞肺癌的近期療效. 南昌大學學報(醫學版), 2013, 53(2):78-80, 96.
35.	胡曉宇. 不可手術胰腺癌¹²⁵I植入治療的系統評價. 新疆醫科大學, 2010.
36.	Goldberg SN, Gazelle GS, Mueller PR. Thermal ablation therapy for focal malignancy:a unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol, 2000, 174(2):323-331.
37.	Lecchi M, Fossati P, Elisei F, et al. Current concepts on imaging in radiotherapy. Eur J Nucl Med Mol imaging, 2008, 35(4):821-837.
38.	羅開元. 實用組織間植入內放射治療惡性腫瘤學. 北京:人民衛生出版社, 2008:39, 77.
39.	魏巍, 沈嘯洪, 孫慧慧, 等. 放射性¹²⁵I粒子植入治療非小細胞肺癌近期療效的多因素分析. 中華內科雜志, 2012, 51(12):978-981.

1. Torres M, Carvalho A, Riera R. Non-invasive positive pressure ventilation for prevention of complications after pulmonary resection in lung cancer patients. Cochrane Database Syst Rev, DOI:10.1002/14651858.CD010355.
2. Ettinger DS, Akerley W, Borghaei H, et al. Non-small cell lung cancer. J Natl Compr Canc Netw, 2012, 10(10):1236-1271.
3. 過為, 李健華, 王峰, 等. 奈達鉑聯合化療治療晚期非小細胞肺癌療效和安全性的Meta分析. 中國循證醫學雜志, 2013, 13(1):47-54.
4. Ettinger DS, Akerley W, Borghaei H, et al. Non-small cell lung cancer, version 2.2013. J Natl Compr Canc Netw, 2013, 11(6):645-653.
5. Solano-Reina S, De Granda-Orive Ji, Jiménez-Ruiz CA. Smoking cessation:an essential component in the treatment of lung cancer patients. Arch Bronconeumol, 2011, 47(9):477.
6. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin, 2009, 59(4):225-249.
7. 王忠敏, 黃鋼, 陳克敏, 等. 放射性粒子組織間植入治療技術指南的建議. 介入放射學雜志, 2009, 18(9):641-644.
8. Martínez-Monge R, Pagola M, Vivas I, et al. CT-guided permanent brachytherapy for patients with medically inoperable early-stage non-small cell lung cancer (NSCLC). Lung Cancer, 2008, 61(2):209-213.
9. 晏欣珺, 鄭長福, 嚴厚君, 等. ¹²⁵I粒子植入聯合GP方案治療局部晚期非小細胞肺癌33例療效評價. 腫瘤學雜志, 2013, 19(5):408-410.
10. Higgins J, Green S. Cochrane Handbook for Systematic Review of interventions Version 5.1.0[updated March 2011]. The Cochrane Collaboration, 2011. Available at:www.cochranehand-book.org.
11. 叢云峰. 放射性¹²⁵I粒子植入治療中晚期肺癌惡性管腔狹窄32例臨床效果探討. 中外健康文摘, 2013, 10(5):102.
12. 郭國華. ¹²⁵I放射性粒子肺內插植聯合吉西他濱+順鉑支氣管動脈灌注化療治療中晚期非小細胞肺癌臨床療效觀察. 中國現代醫生, 2012, 50(32):152-153.
13. 郭志遠, 崔建嶺, 付呂平, 等. ¹²⁵I放射性粒子組織間植入聯合化療治療非小細胞肺癌的研究. 河北醫藥, 2011, 33(8):1134-1137.
14. 賀克武, 高斌, 秦漢林, 等. ¹²⁵I粒子組織間植入聯合支氣管動脈灌注化療治療肺癌的療效觀察. 介入放射學雜志, 2012, 21(7):554-558.
15. 林鋒, 冉鵬, 肖家榮, 等. 術中植入放射性¹²⁵I粒子治療肺癌效果分析. 廣東醫學, 2010, 31(1):104-106.
16. 陸相楊, 王啟飛. ¹²⁵I粒子姑息治療ⅢB期非小細胞肺癌的近期療效觀察. 寧夏醫科大學學報, 2011, 33(6):551-553.
17. 駱紅蕾, 喻曉娟, 李進, 等. ¹²⁵I粒子植入聯合化療治療同期放化療后局部復發的Ⅲ期非小細胞肺癌. 中華核醫學與分子影像雜志, 2013, 33(3):195-198.
18. 鐘輝. CT引導下¹²⁵I粒子植入治療肺癌的價值探討. 健康必讀(下旬刊), 2011, 5:129.
19. 時沛. ¹²⁵I粒子植入聯合NP方案化療治療晚期非小細胞肺癌的臨床研究. 中國誤診學雜志, 2010, 10(1):39-40.
20. 宋愛國, 劉增良, 楊秀貞, 等. 放射性¹²⁵I粒子植入治療局部晚期肺癌的近期療效. 河北醫藥, 2012, 34(6):844-845.
21. 晏欣珺, 鄭長福, 嚴厚君, 等. ¹²⁵I粒子植入聯合GP方案治療局部晚期非小細胞肺癌33例療效評價. 腫瘤學雜志, 2013, 19(5):408-410.
22. 楊樹法, 樊喜文, 張國慶, 等. 放射性¹²⁵I粒子植入聯合化療治療不可手術的局部晚期非小細胞肺癌的療效和安全性. 中華腫瘤雜志, 2010, 32(8):626-629.
23. 趙書元. ¹²⁵I粒子植入聯合支氣管動脈灌注化療治療中晚期肺癌的臨床研究. 中國醫藥指南, 2013, 11(25):87-88.
24. 鄭琳, 郭晨陽, 黎海亮. 吉西他濱、順鉑雙路徑用藥聯合¹²⁵I粒子植入治療Ⅲ期非小細胞肺癌的臨床對照研究. 中華放射學雜志, 2011, 45(4):379-382.
25. 李俊升, 李建華, 王昕, 等. ¹²⁵I放射性粒子術中組織間植入治療Ⅲa期非小細胞肺癌的近期臨床研究. 內蒙古醫學雜志, 2005, 37(4):303-304.
26. 杜學明, 許建輝, 郎建華, 等. ¹²⁵I粒子聯合化療治療非小細胞肺癌. 腫瘤, 2007, 27(5):406-408.
27. 李玉亮, 王永正, 張福君, 等. CT引導下經皮穿刺植入¹²⁵I粒子治療老年中心型肺癌近期療效分析. 中華腫瘤防治雜志, 2007, 14(23):1818-1820.
28. 劉春香, 劉濤, 李德杰, 等. 經支氣管動脈化療藥物灌注術聯合¹²⁵I粒子植入治療老年中心型肺癌近期療效分析. 中華腫瘤防治雜志, 2007, 14(12):951-952.
29. 田立景, 田秀榮. ¹²⁵I粒子內放療聯合化療治療中晚期肺癌52例療效分析. 中國腫瘤臨床, 2008, 35(2):82-84.
30. 王馨, 吳煒新, 王衛星, 等. ¹²⁵I粒子腫瘤內植入聯合吉西他濱治療周圍性非小細胞肺癌. 介入放射學雜志, 2008, 17(3):194-196.
31. 趙化云. 中醫藥聯合¹²⁵I植入對老年中晚期非小細胞肺癌生存質量的臨床觀察. 河南中醫學院, 2008.
32. 張青平, 趙志勇, 林武華, 等. CT導向下¹²⁵I粒子組織間植入治療局部晚期非小細胞肺癌臨床研究(附56例報告). 腫瘤預防與治療, 2009, 22(4):392-394.
33. 胡永進, 杜學明, 吳春娃, 等. ¹²⁵I粒子植入聯合化療對小細胞肺癌生存期的影響. 武警后勤學院學報(醫學版), 2013, 22(7):602-605.
34. 裘海燕, 許飛, 張偉, 等. ¹²⁵I粒子植入聯合化療治療晚期非小細胞肺癌的近期療效. 南昌大學學報(醫學版), 2013, 53(2):78-80, 96.
35. 胡曉宇. 不可手術胰腺癌¹²⁵I植入治療的系統評價. 新疆醫科大學, 2010.
36. Goldberg SN, Gazelle GS, Mueller PR. Thermal ablation therapy for focal malignancy:a unified approach to underlying principles, techniques, and diagnostic imaging guidance. AJR Am J Roentgenol, 2000, 174(2):323-331.
37. Lecchi M, Fossati P, Elisei F, et al. Current concepts on imaging in radiotherapy. Eur J Nucl Med Mol imaging, 2008, 35(4):821-837.
38. 羅開元. 實用組織間植入內放射治療惡性腫瘤學. 北京:人民衛生出版社, 2008:39, 77.
39. 魏巍, 沈嘯洪, 孫慧慧, 等. 放射性¹²⁵I粒子植入治療非小細胞肺癌近期療效的多因素分析. 中華內科雜志, 2012, 51(12):978-981.

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Efficacy and Safety of ¹²⁵I Seed Interstitial Implantation for Lung Cancer: A Meta-analysis