Abstract

Objective: To assess the clinical efficacy, safety, and immune status of advanced non-small cell lung cancer (NSCLC) patients after radiotherapy and chemotherapy with CT-guided 125Ⅰ particles.

Materials and Methods: From January 2016 to June 2022, 34 NSCLC patients who progressed after radiotherapy and chemotherapy were studied retrospectively. There were 34 evaluable lesions, and 125I seeds were implanted into the lesions under CT guidance. The study's endpoints were as follows: Short-term clinical efficacy, quality of life score, and adverse reaction status assessment, with patients being collected from January 2020 to January 2022 for immune status assessment.

Results: The average postoperative follow-up period was 16.58 ± 7.41 months. The one-year postoperative survival rate was 76.47% (26/34), the two-year postoperative survival rate was 58.82% (20/34), and the median overall survival was 16 (6–24) months; one-year PFS after operation The rate was 61.76% (21/34), the two-year PFS rate was 41.18% (14/34), and the median PFS was 12.5 (1–24) months. Postoperative pneumothorax occurred in 11.76% of patients, minor bleeding in 5.88%, and pneumonia in 2.94%, all of which improved after symptomatic treatment. Compared with the preoperative results, the percentage of CD3+ and CD4+T lymphocytes in the treatment group increased 1、2、3 and 6 months after surgery, and the percentage of NK cells increased 3 and 6 months after surgery. Positive immune factor levels of IL-2 and TNF-α were increased at 2、3 and 6 months after surgery, γ-IFN levels were increased at 1、2、3 and 6 months after surgery, IL-4 levels were decreased at 3 and 6 months after surgery, and IL-10 levels were decreased at 6 months after surgery. TH17 (IL-17) levels decreased at 1、2、3and 6 months after surgery.

Conclusion: CT-guided 125Ⅰ particle therapy is an effective treatment for NSCLC that has progressed following radiotherapy and chemotherapy. Local treatments improve patients' quality of life and reduce tumor burden. Ct-guided 125I radioactive seed implantation can improve the immune status of patients with recurrent or progressive NSCLC after radiotherapy and chemotherapy, and enhance the anti-tumor immune response.