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PURPOSE Toprospectivelyevaluatethefeasibilityandclinicalvalueof computedtomography(CT)-guided125Ibrachytherapyin treatingbilaterallungrecurrencesfromcolorectalcarcinoma. METHODS ThisstudywasapprovedbySunYat-senUniversityCancerCenterInstitutionalReviewBoardandallpatientsprovided informedwrittenconsent.Seventy-twopatientswithbilaterallungrecurrencesfromcolorectalcarcinomawereenrolledand randomlydividedinto2groups.Thirty-threewerepercutaneouslytreatedbyCT-guided125Ibrachytherapy(groupA)andthe other39wereonlygivensymptomaticandsupportivetreatments(groupB).Follow-upcontrastCTscanswerereviewedandthe treatmentsefficacywasevaluated.125Ibrachytherapywasconsideredasuccessifitachievedthecomputerizedtreatment planningsystem(TPS)criteria1monthafterprocedure.AnalysesincludedKaplan-Meieranalysis,Mantel-Coxlogranktestand Coxproportionalhazardsregression. RESULTS IngroupA,atotalof37125Ibrachytherapieswereperformedon33patientswith126lungmetastaticlesionsandthe successratewas87.9%(29of33patients).Thelocalcontrolrateof3,6,12,24,36monthswas75.8%,51.5%,33.3%,24.2%,9.1% respectively. A small amount of pulmonary hematoma occurred in 5 patients and 6 patients presented pneumothorax with pulmonary compressionof 30-40%.Nomassive bleedingor radiationpneumonitis occurred.Themean overall survival(OS) of groupAwassignificantlylongerthanthatofgroupBand125IbrachytherapywasanindependentfactoraffectingtheOS(group A,18.8months;groupB,8.6months;HR,0.391;95%CI,0.196-0.779;P=0.008). CONCLUSION CT-guided125Ibrachytherapyisfeasibleandsafeforthetreatmentofbilaterallungrecurrencesfromcolorectal carcinoma.