Analysis of short-term clinical efficacy and immune function changes of advanced non-small cell lung cancer after radiotherapy or chemotherapy under CT-guided 125Ⅰseed implantation

Yunfeng Kou¹Songbai Chen²Yuting Yuan¹Guangsheng Zhao¹Jun Zhou¹Zhe Wang³Ruoyu Wang³Chuang Li^1*

• ¹Department of Intervention, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
• ²Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, 6 Jiefang Street, Dalian, 116001, People's Republic of China., Dalian, China
• ³Department of Medical Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China

Objective: To evaluate the clinical efficacy, safety, and changes in immune status of advanced non-small cell lung cancer (NSCLC) patients with disease progression after chemoradiotherapy treated with CT-guided 125I radioactive seed implantation. 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 125 I 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 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(95% CI:13.7-18.3 ); 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(95% CI:10.8-16.2). 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 125Ⅰparticle therapy may be 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 may improve the immune status of patients with recurrent or progressive NSCLC after radiotherapy and chemotherapy, and enhance the anti-tumor immune response.