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Aim: This study aimed to investigate the technical procedure, safety, and clinical value of the transosseous approach for computed tomography (CT)-guided radioactive 125-iodine (125I) seed implantation for the treatment of thoracic and abdominal lymph node metastases. Subjects and Methods: This was a retrospective study that Nine lymph node metastases in nine patients were treated in our hospital between January 2010 and August 2018. Under CT guidance, at least one puncture path was made through the transosseous approach. The seeds were planted according to the TPS. CT/MRI scans were performed every 2 months after the treatment to evaluate local therapeutic efficacy according to the Response Evaluation Criteria in Solid Tumors. Results: The transosseous approach was successfully established in all patients. The median follow-up time was 11 months (6–36 months). At 2, 4, 6, 8, 10 and 12 months after operation, the objective effective rate and clinical benefit rate were 66.67%, 77.78%, 77.78%, 71.43%, 66.67% and 50.00%; and 88.89%, 88.89%, 88.89%, 71.43%, 66.67% and 50.00%, respectively. The survival rate of the patients at 6, 12, 18, 24, 30 and 36 months after operation was 53.00%, 26.00%, 26.00%, 13.00%, 13.00% and 13.00%, respectively. Conclusions: The transosseous approach for CT-guided radioactive 125I seed implantation was safe, effective, and minimally invasive for the treatment of thoracic and abdominal lymph node metastases
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Objective To evaluate the short-term efficacy, safety and effectiveness of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) combined with radioactive 125I seed implantation in treating advanced non-small-cell lung cancer (NSCLC). Methods A total of 48 patients with inoperable and EGFR mutation-positive advance NSCLC were included in this study. The patients were divided into study group (n = 26) and control group (n = 22). Patients in the study group were treated with EGFR-TKIs combined with radioactive 125I seed implantation; while patients in the control group only received EGFR-TKIs treatment, which was kept on until the disease progressed. The clinical efficacy, and the incidence of side effect as well as the survival rate were determined, and the results were compared between the two groups. Results Local disease control rate of the study group and the control group was 92.3% and 68.2%respectively, the difference was statistically significant (P= 0.033), while the effective rate was 76.9% and 54.5%respectively, the difference was not significant (P=0.101). Progression-free survival (PFS) time of the study group and the control group was 14.1 months and 9.7 months respectively (P< 0.05). The one-year survival rate of the study group and the control group was 80.8%and 63.6%respectively (P<0.05), and the median survival time was 26.9 months and 17.1 months respectively (P < 0.05). The major complication caused by radioactive 125I seed implantation was pneumothorax. Conclusion For EGFR mutation-positive advance NSCLC, EGFR-TKIs together with radioactive 125I seed implantation is a safe and effective treatment.Its short-term efficacy is superior to pure EGFR-TKIs therapy. At present, this combination therapy is a new alternative for the treatment of EGFR mutation-positive advance NSCLC.
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Objective:This study aimed to observe the clinical efficacy of implanting radioactive 125I seeds to treat non-small cell lung cancer (NSCLC) on the basis of the recent changes in serum tumor markers (including CEA, CA125, SCC-Ag, and CYFRA21-1). Methods:We selected 72 patients who were pathologically confirmed with NSCLC and received CT-guided percutaneous implantation of radioactive 125I seeds from January 2009 to June 2012. The concentration of the serum tumor markers was detected 3 d before implan-tation and 1, 2, 3, and 6 months after implantation. Result:All of the operations were successfully completed. One month after implan-tation, a significant change was observed in the concentration of serum tumor markers (CEA, CA125, SCC-Ag, and CYFRA21-1) com-pared with their preoperative levels (P<0.01). No significant difference was observed between the different time points after implanta-tion. Conclusion:The treatment of NSCLC by implanting radioactive 125I seeds can effectively reduce the level of tumor markers. A sig-nificant difference was observed in the level of tumor markers between patients with different efficacy classifications.
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Objective To investigate the efficacy of CT guided radioactive 125I seed implantation on elderly patients with advanced malignancies.Methods 78 cases of elderly patients with malignant were collected and divided into two groups.41 cases of the treatment group were treated with CT guided radioactive 125I seed implantation.Particle activity was 29.6 MBq.The prescription dose was 90-110 Gy.37 cases of the control group were treated with optimized supportive care.Data from all of patients were to review and followup observation in short term efficacy,quality of life and side efforts.Results The total effective rate was 92.7 ％(38/41)and the disease control rate was 97.6 ％(40/41)in the treatment group.The control group was in the effective rate and 16.2 ％(16/37)in the disease control rate.The quality of life of the treatment group was higher than those in the control group(P＜0.05).And there is no obviously side efforts.Conclusion The treatment of elderly patients with advanced malignant tumors by 125I seed implantation was a safe and effective method.It can improve the quality of patients' life.
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Objective To investigate the feasibility and efficacy of ultrasound-guided interstitial implantation of radioactive ~(125)I seed for the treatment of unresectable pancreatic carcinoma.Methods Twenty-one patients with unresectable primary pancreatic carcinoma were treated with interstitial ~(125)I seed implantation under laparotomy.The radioactive activity and the number of implanted seed were determined according to preoperative CT scanning outcomes by using the Treatment Planning System(TPS).The matched peripheral dose(MPD) was 65~110 Gy.The radioactive activity ranged 0.4~0.5 mCi per seed.A total of 10~75 ~(125)I seed were implanted with an 18-gauge seed needle and the Mick applicator under direct visualization or ultrasound guidance.Gastroenterostomy or cholangiojejunostomy were performed in 8 patients before or after the implantation.Postoperative external radiation therapy combined with chemotherapy with gemcitabine was carried out in 2 patients. Stent placement was conducted in 2 patients preoperatively and postoperatively, respectively.Results Out of 15 patients with abdominal pain,complete and partial pain relief were obtained in 7 patients and 7 patients,respectively,at 1~3 postoperative days,the response rate being 93.3%(14/15). Except for 2 cases of loss of follow-up,there were 5 cases of complete response(CR),7 cases of partial response(PR),5 cases of progressive disease(PD),and 2 cases of no change(NC).Of 19 patients,the median survival time was 5 months and the 1-year survival rate was 26.3%.Chylous leakage occurred in 1 patient and seed dislodgement to the liver occurred in 3 patients.No pancreatic fistula or pancreatitis were encountered. Conclusions Radioactive ~(125)I seed implantation for the treatment of pancreatic carcinoma is safe,effective,and micro-invasive,being a good option of remedy.