Computed tomography-guided 125I seed implantation combined with chemotherapy in treating recurrent ovarian cancer / 中国肿瘤临床

ABSTRACT

Objective:To evaluate the safety and efficacy of a palliative regimen of computed tomography (CT)-guided 125I seed im-plantation combined with chemotherapy for recurrent ovarian cancer. Methods:A total of 21 patients with recurrent ovarian cancer, who received 125I seed implantation and chemotherapy, were retrospectively analyzed. Out of the 29 lesions detected, 25 lesions were suitable for 125I seed implantation. Treatment planning system (TPS) was implemented preoperatively to determine the number and dis-tribution of 125I seeds. Under CT guidance, 125I seeds were implanted into the recurrent lesions using the TPS. Within 3 d of 125I seed im-plantation, liposomal paclitaxel was administered by intravenous infusion on day 1 and carboplatin by infusion via the feeding artery of tumor on day 2. Chemotherapy was repeated on a 21-day schedule. Efficacy and complications were evaluated during follow-up. Re-sultsAfter two cycles of chemotherapy, out of the 25 recurrent lesions that underwent 125I seed implantation, four lesions showed com-plete remission, 14 with partial remission, three with stable disease, and four with progression of disease. The objective response rate was 72%, and the pain relief rate was 82.4%. Karnofsky's performance status scores increased dramatically (P=0.019). The median pro-gression-free survival time was 6.8 months, median overall survival time was 14.2 months, and the 1-year survival rate was 42.9%. He-matologic toxicity and gastrointestinal reactions were the primary adverse conditions. No severe radiation complications and treat-ment-related deaths were observed in all patients. Conclusion:CT-guided 125I seed implantation combined with chemotherapy is active and well-tolerated in patients with recurrent ovarian cancer. This combined treatment cannot only significantly enhance the objective re-sponse rate, but also leads to remarkable improvement in cancer-related symptoms.