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

Authors Xiang Z, Wang L, Yan H, Zhong Z, Liu W, Mo Z, Gao F, Zhang F

Received 24 October 2017

Accepted for publication 20 May 2018

Published 27 August 2018 Volume 2018:11 Pages 5183—5193

DOI https://doi.org/10.2147/OTT.S154973

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 3

Editor who approved publication: Professor Jianmin Xu


Zhanwang Xiang,1–3,* Lifei Wang,4,* Huzheng Yan,5 Zhihui Zhong,5 Wangkai Liu,6 Zhiqiang Mo,5 Fei Gao,5 Fujun Zhang5

1Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 2Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-sen University, Guangzhou, China; 3Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China; Guangzhou, China; 4The Department of Radiology, The Third People’s Hospital of Shenzhen, Shenzhen, China; 5Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; 6The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

*These authors contributed equally to this work

Purpose: This study aimed to compare the outcomes of 125I 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 125I 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 (T0), 2, 4, 6, 8, 12, 16, 20, and 24 weeks (T2, T4, T6, T8, T12, T16, T20, and T24) 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 T2, T4, T6, T16, T20, and T24. Group A was superior to group B concerning quality of life scores (T2, T4, T20, and T24), cost-effectiveness, and number of treatment appointments. No significant differences were observed for complications.
Conclusion: Compared with EBRT, 125I seed brachytherapy can be an alternative method for painful bone metastases from lung cancer after one cycle of chemotherapy progression.

Keywords: pain, 125I seed, brachytherapy, EBRT, bone metastases, lung cancer, chemotherapy

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