A study on the learning curve for a new radioactive seed template retainer assisted by CT-guided radioactive seed implantation for advanced non-small cell lung cancer

Objective

To explore the application of a new radioactive seed template retainer in the learning curve of CT-guided ¹²⁵I seed brachytherapy (CTISBT) for advanced non-small cell lung cancer (NSCLC).

Methods

This study retrospectively analyzed the medical records of 60 patients who underwent CTISBT for advanced NSCLC by a single physician between January 2018 and December 2019. The data were sorted in order of admission and divided into three groups according to the order of surgery, group A (cases 1–20), group B (cases 21–40), and group C (cases 41–60). All patients underwent preoperative planning and postoperative dosimetry verification, and the operation time, intraoperative CT scans, postoperative hospital stay, and postoperative complications were compared among the three groups. The quality of life (QOL) score and tumor volume were compared before and 2 months after surgery.

Results

There were no statistically significant differences among the three groups in QOL scores, tumor volume, and tumor site before CTISBT assisted by the new radioactive seed template retainer. However, the surgical time differed significantly between the three groups (P ​< ​0.01). The operation time was longer in group A than that in groups B and C (P ​< ​0.01). There was no significant difference between groups B and C. There were no significant differences in the number of CT scans among the three groups and the length of postoperative hospital stay. The follow-up QOL and tumor volume were significantly reduced at 2 months after surgery compared with those before surgery (P ​< ​0.01).

Conclusions

The short-term efficacy of the new radioactive seed template retainer-assisted CTISBT was definitive for advanced NSCLC. After the physician had accumulated experience with 20 cases of a new type of radioactive seed template retainer-assisted CTISBT surgery, the follow-up operation time was significantly shortened and the learning curve entered the plateau stage.