Efficacy and Safety of Immune Checkpoint Inhibitors Combined with Iodine-125 Seed Implantation in Driver-Gene-NSCLC: A Retrospective Study

Abstract

Retrospective analysis of 95 patients with driver gene-negative NSCLC who visited First Affiliated Hospital of Army Medical University between December 2018 and December 2023. Among them, 33 cases in the observation group were treated with I¹²⁵ seed implantation combined with chemotherapy and ICIs(ICIs + CT + I¹²⁵), and 62 cases in the control group were treated with extracorporeal radiotherapy combined with chemotherapy and ICIs(ICIs + CT + RT). The primary observational endpoint was median progression-free survival(mPFS), while the secondary observational endpoints included the 1 and 2-year PFS rate and the incidence of adverse events. mPFS was not reached in the observation group and 11.8 months(95%CI 9.743–13.857) in the control group, a statistically significant difference(P<0.001). The restricted mean survival time (RMST) was 22.2(95% CI 18.257–26.101) and 13.8 months (95% CI 11.912–15.718) in both groups at 31.7 months, PFS was better in the observation group than in the control group. In the observation group, 2 cases(6.1%) developed grade 3 pneumothorax or hemorrhage, and in the control group, 16 cases(25.8%) developed grade 3 radiation pneumonitis, which was higher in the control group than in the observation group (P = 0.019). Compared to radiotherapy in combination with chemotherapy and immunotherapy, patients with driver gene-negative NSCLC who received I¹²⁵ seed implantation had greater advantages about their longer survival and fewer adverse effects.