Computed tomography-guided implantation of 125 I 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 I-125 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 I-125 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 I-125 seed is a safe and effective alternative treatment option.