Limited resection for non-small cell lung cancer: Observed local control with implantation of I-125 brachytherapy seeds

Background. Limited resection for lung cancer has been associated with a relatively high incidence of local recurrence. This retrospective study evaluates the impact of implanting radioactive iodine-125 (I-121) seeds along the resection margin in these patients. Methods. Thirty-three patients with lung cancer who were not candidates for lobectomy or pneumonectomy underwent a limited resection of 35 primary non-small cell lung cancers. I-125 brachytherapy seeds were implanted along the resection margin to reduce the risk of local recurrence. Survival using the Kaplan-Meier method and sites of recurrence were documented. Follow-up ranged from 20 to 98 months (median, 51 months). Results. The 5-year survival was 47% for all patients. For patients with T1NO tumors, it was 67%, and for patients with T2NO tumors, it was 39%. However, the cancer-specific survivals were 77% and 53% for patients with T1NO and T2NO tumors, respectfully. Ten patients experienced recurrence, with two local (at the resection margin) and six regional recurrences (five mediastinum, one chest wall). Both local recurrences and one regional recurrence occurred in the 19 patients with TINO tumors. Conc(l)usions. ,(215) seed implantaIion along the resected margin for compromised patients undergoing limited resection of lung cancer results in a relatively. (C) 20003 by The Surgeons Thoracic Surgeons.