Efficacy and safety of iodine-125 seed implantations combined with chemotherapy and immunotherapy for patients with non-small cell lung cancer: protocol for a systematic review and meta-analysis

Background Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related mortality worldwide, with conventional treatments often limited by radiation resistance, systemic toxicity and poor outcomes in advanced stages. Iodine-125 (I-125) seed implantation, combined with chemotherapy and imm...

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Main Authors: Hao-yu Zhang, Kuanghao Wu, Hong-yan Zheng, Xin-yu Song
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/4/e094632.full
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author Hao-yu Zhang
Kuanghao Wu
Hong-yan Zheng
Xin-yu Song
author_facet Hao-yu Zhang
Kuanghao Wu
Hong-yan Zheng
Xin-yu Song
author_sort Hao-yu Zhang
collection DOAJ
description Background Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related mortality worldwide, with conventional treatments often limited by radiation resistance, systemic toxicity and poor outcomes in advanced stages. Iodine-125 (I-125) seed implantation, combined with chemotherapy and immunotherapy, has emerged as a promising therapeutic strategy, but its efficacy and safety compared with conventional external beam radiotherapy combined with systemic therapies remain unclear. This systematic review and meta-analysis aims to synthesise the available evidence to evaluate the comparative benefits and risks of these treatment modalities.Methods and analysis Two reviewers will independently search seven databases—PubMed, Embase, Web of Science and the Cochrane Library—for randomised controlled trials (RCTs). These RCTs should compare the efficacy and safety of I-125 seed implantations combined with chemotherapy and immunotherapy against chemoradiotherapy combined with immunotherapy in patients with NSCLC. The risk of bias in the included studies will be evaluated using the Revised Cochrane risk-of-bias tool V.2. Data synthesis will be conducted using RevMan software. Trial sequential analysis will be applied to the primary outcomes. Additionally, subgroup and sensitivity analyses will be performed to assess the robustness of the findings.Ethics and dissemination Ethical approval is not required because this study is a secondary analysis of existing data. We will disseminate the findings through peer-reviewed publications.PROSPERO registration number CRD42024591684.
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spelling doaj-art-87cc74afe28f4e6cb1696dfc10cad9dc2025-08-20T03:47:44ZengBMJ Publishing GroupBMJ Open2044-60552025-04-0115410.1136/bmjopen-2024-094632Efficacy and safety of iodine-125 seed implantations combined with chemotherapy and immunotherapy for patients with non-small cell lung cancer: protocol for a systematic review and meta-analysisHao-yu Zhang0Kuanghao Wu1Hong-yan Zheng2Xin-yu Song3Department of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, Yichang, People’s Republic of ChinaDepartment of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, Yichang, People’s Republic of ChinaDepartment of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, Yichang, People’s Republic of ChinaDepartment of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, Yichang, People’s Republic of ChinaBackground Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related mortality worldwide, with conventional treatments often limited by radiation resistance, systemic toxicity and poor outcomes in advanced stages. Iodine-125 (I-125) seed implantation, combined with chemotherapy and immunotherapy, has emerged as a promising therapeutic strategy, but its efficacy and safety compared with conventional external beam radiotherapy combined with systemic therapies remain unclear. This systematic review and meta-analysis aims to synthesise the available evidence to evaluate the comparative benefits and risks of these treatment modalities.Methods and analysis Two reviewers will independently search seven databases—PubMed, Embase, Web of Science and the Cochrane Library—for randomised controlled trials (RCTs). These RCTs should compare the efficacy and safety of I-125 seed implantations combined with chemotherapy and immunotherapy against chemoradiotherapy combined with immunotherapy in patients with NSCLC. The risk of bias in the included studies will be evaluated using the Revised Cochrane risk-of-bias tool V.2. Data synthesis will be conducted using RevMan software. Trial sequential analysis will be applied to the primary outcomes. Additionally, subgroup and sensitivity analyses will be performed to assess the robustness of the findings.Ethics and dissemination Ethical approval is not required because this study is a secondary analysis of existing data. We will disseminate the findings through peer-reviewed publications.PROSPERO registration number CRD42024591684.https://bmjopen.bmj.com/content/15/4/e094632.full
spellingShingle Hao-yu Zhang
Kuanghao Wu
Hong-yan Zheng
Xin-yu Song
Efficacy and safety of iodine-125 seed implantations combined with chemotherapy and immunotherapy for patients with non-small cell lung cancer: protocol for a systematic review and meta-analysis
BMJ Open
title Efficacy and safety of iodine-125 seed implantations combined with chemotherapy and immunotherapy for patients with non-small cell lung cancer: protocol for a systematic review and meta-analysis
title_full Efficacy and safety of iodine-125 seed implantations combined with chemotherapy and immunotherapy for patients with non-small cell lung cancer: protocol for a systematic review and meta-analysis
title_fullStr Efficacy and safety of iodine-125 seed implantations combined with chemotherapy and immunotherapy for patients with non-small cell lung cancer: protocol for a systematic review and meta-analysis
title_full_unstemmed Efficacy and safety of iodine-125 seed implantations combined with chemotherapy and immunotherapy for patients with non-small cell lung cancer: protocol for a systematic review and meta-analysis
title_short Efficacy and safety of iodine-125 seed implantations combined with chemotherapy and immunotherapy for patients with non-small cell lung cancer: protocol for a systematic review and meta-analysis
title_sort efficacy and safety of iodine 125 seed implantations combined with chemotherapy and immunotherapy for patients with non small cell lung cancer protocol for a systematic review and meta analysis
url https://bmjopen.bmj.com/content/15/4/e094632.full
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