125I brachytherapy in the palliation of painful bone metastases from lung cancer after failure or rejection of conventional treatments
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Zhanwang Xiang1,*, Zhiqiang Mo1,*, Guohong Li1,*, Saba Gilani2, Zhihui Zhong1, Tao Zhang1, Fujun Zhang1, Fei Gao1
1Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Imaging and Intervention Therapy Department, Guangzhou 510060, Guangdong, China
2Midtown Medical Center, Columbus, GA 31901, USA
*These authors have contributed equally to this work
Fujun Zhang, e-mail: firstname.lastname@example.org
Fei Gao, e-mail: email@example.com
Keywords: pain, 125I seed, brachytherapy, bone metastases, lung cancer
Received: November 23, 2015 Accepted: February 11, 2016 Published: February 23, 2016
Purpose: This study sought to assess the safety and effect of 125I seed implantation for palliation of painful bone metastases from lung cancer after failure or rejection of conventional treatments.
Materials and Methods: 89 patients with painful bone metastases secondary to lung cancer were consented and enrolled in this study from June 2013 to May 2015. All patients had failed or refused conventional treatments underwent percutaneous CT-guided 125I seed implantation. The Brief Pain Inventory (BPI) was used to measure pain intensity prior to treatment (T0), 2, 4, 6, 8 and 12 weeks (T2, T4, T6, T8 and T12) after treatment in a 24-hour period. Analgesic, quality of life (QOL) scores and complications were also recorded. Four patients were excluded as they were lost to follow-up or had incomplete data.
Results: 85 patients with 126 bone metastases from lung cancer were treated. There were significantly lower scores after treatment in the visual analog scale (VAS) and analgesic. The VAS scores for worst pain was 6.3±1.8 at T0. At T2, T4, T6, T8 and T12, the score in a 24-hour period decreased to 4.9±1.2 (P<0.01), 3.7±1.3 (P<0.01), 3.4±1.2 (P<0.01), 2.6±0.9 (P<0.01), and 1.4±0.8 (P<0.01) respectively. Comparison of QOL scores showed improvements including sleep, appetite, spiritual state, and fatigue at T2, T4, T6, T8 and T12 when compared to T0. No serious complications or massive bleeding were observed.
Conclusions: 125I brachytherapy is a safe and effective method for palliation of painful bone metastases from lung cancer after failure or rejection of conventional treatments.
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