ABSTRACT
Objective To evaluate the efficacy of percutaneous CT guided interstitial 125Ⅰ seeds implantation treatment for refractory pelvic malignant tumors and discuss the procedure of technique.Methods Twenty-three patients with refractory pelvic malignant tumors(25 lesions,diameter 3.5-7.0 cm,mean 4.5 cm) showing failure response to full chemotherapy and/or radical radiotherapy after tumors resection were undergone percutaneous CT guided intratumoral 125Ⅰseed implantation.Treatment plan system(TPS)was used to design the distribution and number of 125Ⅰ seeds according to matched peripheral dose(MPD)1-3 days before the procedure.Of which 6 cases received combined internal iliac arterial infusion chemotherapy before or after the 125Ⅰ seed implantation procedure.Results 9 ～ 75(mean 27)125Ⅰ seeds were implanted into a single tumor at first time including 6 patients with intraarterial chemotherapy for 14 cycles(mean 2.3 cycles),showed relief of clinical pain symptoms in 16 of 23 cases,72 h ～ 4 w after the seeds implantation;with the an effective rate of 69.6%.Follow up for 2-34 months(median,21 months),CT or MRI performed 2 months after the seeds implantation showed no CR,but PR in 18 cases,SD in 4 cases,and PD in 1 case,with overall response rate of 78%(18/23),and no serious complication.In addition,20 cases survived,with the longest one of 34 months and the other 3 died.Conclusions Intratumoral 125Ⅰ seeds implantation under CT guidance for pelvic refractory malignant tumors is safe,minimally invasive,and effective.