Combination Treatment with Iodine 125 Seeds Implant and Systemic Therapy vs. Systemic Therapy Alone for Non-small Cell Lung Cancer: A Systematic Review and Meta-analysis

Li et al., 2023 | J Coll Physicians Surg Pak | Meta Analysis

Citation

Li Huzi, Li Wentao, ... Zhang Hong. Combination Treatment with Iodine 125 Seeds Implant and Systemic Therapy vs. Systemic Therapy Alone for Non-small Cell Lung Cancer: A Systematic Review and Meta-analysis. J Coll Physicians Surg Pak. 2023-Jan;33(1):84-91. doi:10.29271/jcpsp.2023.01.84

Abstract

Combination treatment with iodine 125 seeds implant and systemic therapy in patients with non-small-cell lung cancer (NSCLC) is a promising treatment practice. The present study aimed to assess the relative efficacy and toxicity of combination treatment versus systemic therapy alone in patients with NSCLC. Databases including PubMed, EBSCO, Web of Science, EMBASE, Cochrane Library, CNKI, and WanFang were searched for relevant randomised controlled trials (RCTs). Risk ratios (RR) were obtained for evaluating indicators in the present meta-analysis including complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), overall response rate (ORR), disease control rate (DCR), one-year and two-year overall survival (OS) rate and complications. A total of 17 eligible RCTs incorporating 1315 patients who underwent combination treatment or systemic therapy alone were ultimately included in this meta-analysis based on our selection criteria. The results showed that CR (RR = 1.89, 95% confidence interval [CI]: 1.53 - 2.33, p <0.001), PR (RR = 1.28, 95%CI: 1.12 - 1.46, p = 0.0002), ORR (RR = 1.46, 95%CI: 1.34 - 1.58, p <0.001), DCR (RR = 1.11, 95%CI: 1.04 - 1.18, p = 0.001), two-year OS (RR = 1.52, 95% CI: 1.30 - 1.77, p <0.001) were higher and SD (RR = 0.53, 95%CI: 0.42 - 0.66, p <0.001) and PD (RR = 0.39, 95%CI: 0.29 - 0.55, p <0.001) were lower in the combination treatment group than in control group. Meanwhile, there was no significant difference in one-year OS (RR = 1.13, 95% CI: 0.98-1.31, p = 0.10). In terms of adverse events, the combination therapy significantly increased the incidence of pneumothorax (RR = 4.91, 95% CI: 2.63 - 9.17, p <0.001); however, no significant differences were found in the incidence of myelosuppression and gastrointestinal symptoms. Combination treatment with iodine 125 seeds implant and systemic therapy can significantly improve clinical response and prolong two-year OS in NSCLC patients without increasing the incidence of myelosuppression and gastrointestinal symptoms, except pneumothorax. Key Words: Brachytherapy, Radioactive seeds, NSCLC, Systemic therapy.

Key Findings

Key Words: Brachytherapy, Radioactive seeds, NSCLC, Systemic therapy.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population non
Sample Size 1315
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Carcinoma, Non-Small-Cell Lung
  • Lung Neoplasms
  • Antineoplastic Agents
  • Pneumothorax
  • Iodine Radioisotopes

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Systematic Review, Meta-Analysis, Journal Article
  • Vertical: iodine

Provenance


Source extracted via PubMed E-utilities API on 2026-04-09