Retrospective study on CT-guided iodine-125 radioactive seed implantation for non-small cell lung cancer patients with severe pulmonary dysfunction: Analysis of efficacy and safety.

OBJECTIVE: To evaluate the efficacy and safety of CT-guided iodine-125 (¹²⁵I) radioactive seed implantation in non-small cell lung cancer (NSCLC) patients with severe pulmonary dysfunction. METHODS: A retrospective analysis was performed on 56 NSCLC patients with severe pulmonary dysfunction who underwent ¹²⁵I seed implantation at Nanchong Central Hospital from January 2020 to December 2024. Short-term efficacy, survival outcomes, pulmonary function, Karnofsky Performance Status (KPS), and adverse events were observed. Prognostic factors were analyzed by Cox regression. RESULTS: The 1-year objective response rate (ORR) was 60.7% and disease control rate (DCR) was 67.9%. The median overall survival (OS) was 18.0 months, and median progression-free survival (PFS) was 13.0 months. Multivariate analysis showed that tumor maximum diameter, D90 ≥120 Gy, and postoperative systemic therapy were independent prognostic factors for OS and PFS. The most common adverse event was pneumothorax requiring drainage (25.0%), with no grade ≥3 radiation pneumonitis or treatment-related deaths. Pulmonary function and KPS scores showed no significant deterioration within 12 months postoperatively. CONCLUSION: CT-guided ¹²⁵I seed implantation is effective and safe for NSCLC patients with severe pulmonary dysfunction, with favorable tumor control and survival while preserving pulmonary function without significant decline within 12 months.