125Iodine brachytherapy stents for lung cancer with superior vena cava syndrome

AIM: To determine the feasibility and efficacy of 125Iodine brachytherapy stent (IBS) for lung cancer associated with superior vena cava syndrome (SVCS). METHODS: From May 2018 to August 2022, a retrospective analysis of 76 patients diagnosed with SVCS who underwent SVC stenting in our department. The ISB group (n = 33) underwent self-expandable metallic stent (SEMS) combined with 125Iodine seed strand implantation (called ISS), while the conventional stent group (n = 43) underwent SEMS implantation alone. The primary endpoints were technical success, clinical success, complications, stent patency, Karnofsky score; secondary endpoints were progression free survival (PFS) and overall survival (OS). RESULTS: There was a significant difference in the stent patency (93.93% vs. 76.74% at 4 months) and Karnofsky scores [(81.52 ± 7.95) vs. (77.44 ± 7.90) at 1 month, all P < 0.05] between the ISB and conventional stent groups (P < 0.05). No statistically significant differences were observed between two groups in technical success (100% vs. 100%), clinical success (96.97% vs. 93.02%), complication rates (24.24% vs. 11.63%), median PFS (3.40 vs. 3.80 months), or median OS (20.40 vs. 20.40 months) (P > 0.05). CONCLUSION: The ISB can effectively relieve SVCS, improve functional status, and prolong stent patency, while showing no significance on PFS and OS. TRIAL REGISTRY: Ethics Committee of Scientific Research and Clinical Trial, The First Affiliated Hospital of Zhengzhou University. Unique identifying number: Ethics Approval Number: 2023ky0106. Date of registration: 2023.01.12.