Table II.
Profile of patients with non-small cell lung cancer.
| A, Intraoperative 125I implantation group | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Patient no. | Number of the particles 22.4–29.6MBq/particle/dose of external irradiation (Gy) | Time until local recurrence (months) | Time until distant metastasis (months) | Overall survival (months) | Duration of follow-up (months) | Site of residual disease | Lymph node metastasis | Post-operative radio-/chemo-therapy | Cause of mortality |
| 1 | 4/120 | 0 | 36 | 36 | 36 | Resection margin in the right upper lobe, residual cancer of the failure bronchial stump (T residual) | No metastasis | 2 cycles of DDP+PTX | Pulmonary |
| 2 | 6/110 | 0 | 18 | 34 | 34 | Left upper hilum, tumor residuals at the bronchial stump and the surface of the pulmonary artery (T residual) | Residual cancer of bronchial stump | 2 cycles of DDP+PTX | Bone and abdominal metastases |
| 3 | 12/120 | 0 | 24 | 31 | 31 | Group 5 lymph nodes were closely adhered to the pulmonary artery Group 6 lymph nodes covered the phrenic nerve (N residual) | Residual and fixation of groups 5 and 6 lymph node in the left upper lobe, which were not resected | 4 cycles of GEM+DDP | Pulmonary failure |
| 4 | 4/110 | 0 | 6 | 12 | 11 | Left middle lobe; tumor invaded the phrenic nerve lymph node (T residual) | 1×2 cm patchy lymph node residual next to the right phrenic nerve | 4 cycles of DDP+PTX | Thoracic cavity metastases, pulmonaryfailure |
| 5 | 7/120 | 0 | 9 | 16 | 16 | Mediastinal lymph node, ascending aortic, and aortic window lymph node enlargement and fixation (N residual) | 4R (3/3), group 10 (6/8), group 11 (1/1) | 6 cycles of GEM+DDP; 1 course of head R-knife | Head and clavicle metastasis, superior vena cava blockage |
| 6 | 6/110 | 0 | 14 | 16 | 16 | Adhesion between subcarinal lymph node and the main bronchus (N residual) | Subcarinal lymph node 2×2.5 cm | 3 cycles of GEM+DDP | Hydrothorax and ascites, systemic metastases, pulmonary failure |
| 7 | 19/130 | 0 | 6 | 26 | 26 | Enlargement of the upper mediastinal lymph node and adhesion to the superior vena cava and main bronchus (N residual) | Group 4 (1/1) | 6 cycles of PC; 1 course of head R-knife | Head metastases |
| 8 | 9/120 | 40 | 44 | Survival | 48 | Tumor invasion of the bronchial stump; enlargement of the peribronchial lymph node and fixation in the left lower lobe (T and N residual) | Group 4 (1/1), group 7 (1/1), group 10 (1/1), group 11 (4/11) | 1 cycle of PC, the patient refused radio-/chemo- therapy following recurrence | Survival |
| 9 | 14/110 | 0 | 0 | Survival | 24 | Partial pericardial invasion with the lymph node under the aortic arch in the left lung (N residual) | Pericardial invasion; adhesion and fixation of the lymph node under the aortic arch | 4 cycles of PC | Survival |
| 10 | 4/120 | 0 | 7 | 12 | 11 | Right lower lobe bronchial stump, tumor invasion of the enlarged lymph nodes at the upper lobe (N residual) | Group 10 (2/5), residual cancer at the bronchial stump lymph node | 3 cycles of PTX+DDP | Chest, back, limb, and spine metastases, hydrothorax and ascites |
| 11 | 10/100 | 0 | 0 | Survival | 18 | Enlargement of the lymph node at 4 cm posterior to the vena cava (N residual) | Fixation of the groups 4, 5, and 6 lymph node | 4 cycles of PC | Survival |
| 12 | 30//130 | 0 | 3 | 24 | 24 | Paratracheal lymph node fixation (~4×3×2 cm) inthe right upper lobe (N residual) | Group 3A (1/1), carinal and paratracheal lymph nodes were not removed | 4 cycles of PC, 1 course of head R-knife and radiotherap for recurrent tumor | Recurrence of the head metastases |
| B, Conventional postoperative external irradiation group | |||||||||
| 1 | 60 | 0 | 3 | 8 | 8 | Dense paratracheal adhesion, titanium clip marked stump (N residual) | Groups 4 and 7 (5/5) | 3 cycles of PC 3 | Radiation pneumonitis, pulmonary failure |
| 2 | 50 | 6 | 0 | 18 | 18 | Residual cancer of bronchial stump, titanium clip marked stump (T residual) | No lymph node metastasis | 4 cycles of GEM+DDP | Local recurrence of lung cancer, bone metastases |
| 3 | 60 | 0 | 1 | 3 | 3 | Enlargement of the lymph nodes anterior to the bronchus and invasion of the left pulmonary artery (N residual) | Group 7 (2/3) | 1 cycle of GEM+DDP | Intracranial metastases |
| 4 | 50 | 2 | 0 | 6 | 6 | Residual cancer of bronchial stump and the vein at the middle lobe (T residual) | No lymph node metastasis | 1 cycle of GEM+DDP | Local recurrence, radiation pneumonitis |
| 5 | 60 | 0 | 24 | 33 | 33 | Frozen-shape of the superior mediastinal lymph nodes and bronchus (N-residual) | Group 7 (2/2) | 6 cycles of docetaxel +DDP | Brain metastases, pulmonary failure |
| 6 | 50 | 3 | 0 | 8 | 8 | Enlargement of the lymph nodes at the intermediate bronchus and inferior lobar bronchus (N residual) | Group 11 (2/2) | 4 cycles of GEM+DDP | Pulmonary failure, systemic bone metastases |
| 7 | 50 | 0 | 18 | 32 | 32 | Hilar lymph node metastases (N-residual) | Para- bronchial stump; group 2 and 4 lymph node metastases (3/4, 7/7, 1/1) | 4 cycles of PC | Pulmonary failure, systemic bone metastases |
| 8 | 40 | 0 | 24 | Survival | 36 | Dense adhesion of the lymph nodes at the basal segments of the right lower lobe, superior segmental bronchus, and right inferior pulmonary vein (N-residual) | Group 10 (1/2) | 3 cycles of docetaxel+ DDP | Left lung metastases 24 months' post-operation |
| 9 | 60 | 6 | 0 | 12 | 12 | Cancer invasion of the bronchial stump lymph nodes and fibrous tissues (T-residual) | No lymph node metastasis | 4 cycles of docetaxel+ DDP | Systemic pleura, bone and celiac lymph node metastases |
| 10 | 50 | 0 | 4 | 32 | 32 | Bifurcation of the middle and lower lobes, carinal lymph node enlargement (N-residual) | No lymph node dissection | 4 cycles of PC | Liver, intracranial, and bone metastases |
| 11 | 55 | 2 | 0 | 7 | 7 | Bronchial stump (T-residual) | Group 4 (1/3), group 10 (2/2) | 4 cycles of GEM+DDP | Local recurrence, radiochemotherapy complications |
DDP, cisplatin; PC, pemetrexed andcarboplatin; PTX, paclitaxel; GEM, gemcitabine; 4R, fourth group of nodes on the right; T-residual disease, incomplete resection of primary tumor but complete dissection of regional lymph node; N-residual disease, complete resection of primary tumor but incomplete resection of metastatic regional lymph node.