Endoscopic ultrasonography guided interstitial iodine 125 seed implantation in treatment of unresectable pancreatic cancer / 中华消化杂志

ABSTRACT

Objective To analyze the effect of endoscopic ultrasonography guided interstitial iodine 125 seed implantation in treatment of unresectable pancreatic cancer and migration of implanted seeds. Methods A total of 17 patients with unresectale pancreatic cancer underwent endoscopic ultrasono- graphy guided interstitial iodine seeds implantation.The therapeutic plan system was used to calculate the number of implanted seeds before procedure.The patients were followed-up monthly and tumor alteration and migration number or loss of implanted seeds were investigated by abdominal plain film.Results Io- dine 125 seeds were successfully implanted in all patients under endoscopic ultrasonography. Before treatment,the median size of tumor was 5.4cm(ranged from 3.7 to 9.0cm)and the number of implan- ted seeds was 27,with median 14(ranged from 7 to 24)once for 2 times.The mean radioactivity per seed was(0.6894?0.016)mCi.The patients were follow-up of 2 to 14 months(mean 4.8 months). Three months after implantation,partial relief was observed in 5 patients(29.4%),no change in 7 patients(41.2%)and progressing in 5 patients(29.4%).The implanted seeds migrated into spleen in 1 case, into liver in 1 case and into bowel in 3 cases.The seeds loss was found in 4 patients.Conclusions Endoscopic uhrasonography guided interstitial implantation of iodine 125 seeds in treatment of advanced pancreatic cancer may significantly inhibit tumor growth,and attention must be paied on the complications of seeds migration or loss,which will impair the nearby organs because of its radioactivity.