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Objective: To observe the safety and efficacy of coaxial puncture 125I seed implantation in treatment of locally advanced pancreatic head and neck cancer. Methods: Totally 21 patients with locally advanced pancreatic cancer were retrospectively analyzed. Preoperative planning was performed with treatment planning system (TPS) and fan-shaped distributed system simulated in the same plane. 125I seeds were implanted using coaxial puncture technology, and was operative plan real-timely adjusted during operation. After operation, CT images were imported into TPS for dose verification. Abdominal CT scanning were performed 2, 4 and 6 months after operation to evaluate the treatment efficiency and local control rate, and intraoperative and postoperative complications were counted. Results: The operations were successfully completed in all patients. The effective rate of treatment 2, 4 and 6 months after operation was 38.10% (8/21), 47.62% (10/21) and 52.38% (11/21),and the local control rate was 95.24% (20/21), 80.95% (17/21) and 80.95% (17/21), respectively. Intraoperative complications included 2 cases of local abdominal hemorrhage, 2 cases of subcutaneous soft tissue hematoma and wrong puncture of pancreatic duct in 1 case. Post operation, fever and appetite loss occurred in 10 and 3 cases, respectively. Among 21 patients, grade 0 and grade acute radiation enteritis were observed in 18 and 3 cases, respectively. Conclusion: Coaxial puncture 125I particle implantation technology is safe and effective for treatment of locally advanced pancreatic head and neck cancer.
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Objective: To explore the value of CT-guided radioactive 125I seed implantation for treatment of vein tumor thrombi in patients with primary hepatocellular carcinoma (HCC). Methods: Data of 10 patients with primary HCC complicated with vein tumor thrombi were analyzed retrospectively. Among them, 8 cases combined with portal vein tumor thrombi and 2 cases combined with hepatic vein tumor thrombi. Radioactive 125I seed implantation for vein tumor thrombi was performed. Treatment planning system (TPS) was used to make preoperative plan, and dose verification was performed immediately after operation. The effective rate and local control rate of cancer thrombi were observed up till 6 months after operation. Survival analysis was performed, and intraoperative and postoperative complications were analyzed. Results: 125I seed implantation was successfully completed in all patients. No recurrence of tumor thrombus occurred during post-operation follow-up. The effective rate was 90.00% (9/10), and the disease control rate reached 100% (10/10) 6 months after operation. Postoperative overall survival was 8-36 months. The 1-year and 2-year survival rate was 70.00% and 40.00%, respectively. Intraoperative hepatic hemorrhage and hepatic pain were observed each in 2 cases, while postoperative mild nausea and decreased appetite occurred in 2 cases. No acute and late radiation damage and serious complications occurred. Conclusion: CT-guided radioactive 125I seed implantation is safe and effective for treatment of vein tumor thrombi in patients with primary HCC.
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Objective To study the safety and effectiveness of modified radioactive 125I seed implantation in treatment of lung cancer patients with poor lung function. Methods Thirty one lung cancer patients with poor lung function were enrolled into this study. All of them were implanted 125I seed with technology of fan-shaped distribution and coaxial puncture. Brachytherapy planning system(TPS) was used to draw up a preoperative implantation plan. Fan-shaped seed distribution system was used to simulate surgical program, and implantation pitch was 0.5 to 1.0 cm. Real-time adjustment is necessary during surgery. Dose distributions were checked by TPS immediately after implantation. Match peripheral dose(MPD),the dose of 90% tumor volume(D90)and the tumor volume covered by 90% prescription dose(D90)were calculated. Intraoperative and postoperative surgery-related complications were analyzed. All patients were followed up to 6 months, at month 2, 4 and 6 post-procedure, CT scan was performed to evaluate the local control rate of tumors. Results The technical success rate was 100% for placement of the 125I seed. MPD of the tumors was 90 to 140 Gy. D90 was 95 to 146 Gy,median dose was 118 Gy.V90 was 92%to 97%,median dose was 94%. Surgery-related complications included pulmonary hemorrhage(1 patient), pleural cavity hemorrhage (2 patients), pneumothorax(2 patients). The 2-month, 4-month and 6-monthlocal control rates were 31%(10/32), 78%(25/32) and 90%(29/32)respectively. The overall complete remission(CR) rate was18%(6/32), partial response(PR) rate was 72%(23/32), stable disease(SD)rate was6%(2/32), progression disease(PD) rate was 3%(1/32).Acute radiation pneumonitis Grade 0 in 29 patients, Grade Ⅰin 4 patients; advanced radiation pneumonitis:grade 0 in 30 patients and gradeⅠin 3 patients. Conclusions The technology of fan-shaped distribution and coaxial puncture for radioactive 125I seed implantation was safe and effective to treat lung cancer patients with poor lung function.