Background: Salvage treatments for recurrent NSCLC after first-line chemotherapy remain challenging. This study was conducted to evaluate the clinical value of microwave ablation (MWA) and iodine-125 brachytherapy, including overall survival (OS), disease free survival (DFS), local control, hospital stay, and health economics.
Methods: The data of 51 and 32 patients who were treated with MWA and brachytherapy was retrospectively analyzed. The number of lesions was limited up to two, with a diameter <4 cm and patients diagnosed with unilateral lung disease. Peripheral tumors were treated with MWA, while lesions close to the hilum were treated with brachytherapy. Contrast-enhanced CT, blood cell count, coagulation function, liver & kidney function and tumor markers were performed for two years, with complications calculated. OS, DFS, local control rate, toxicity, hospital stay and expense were recorded.
Results: The one and two-year OS rates were 96.08% and 92.16% versus 96.88% and 90.62% in the MWA and brachytherapy groups, respectively. The one and two-year DFS rates were 92.16% and 76.47% versus 93.75% and 78.13%, respectively. No significant differences were observed in log-rank analysis between the groups. Local control rates at six and 12 months were 100% and 96.08% versus 100% and 96.88%, while incidences of pleural effusion were 3.92% and 3.13%, respectively (P < 0.05). Medical cost was 3356.73 ± 206.87 and 6714.28 ± 35.43 U.S. dollars (P = 0.014).
Conclusion: MWA and brachytherapy are effective and safe options for the treatment of NSCLC recurrence after first-line chemotherapy. Which modality should be considered is dependent upon tumor location, tumor size and experience of specialists.
Keywords: Brachytherapy; health economics; iodine; microwave ablation.
© 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.