Preliminary investigation of computed tomography-guided iodine-125 seed implantation treatment efficacy in patients with iliac lymph nodes metastases.

OBJECTIVES: The objective of this study is to assess the technical feasibility, safety, and efficacy of computed tomography (CT)-guided iodine-125 (125 I) seed implantation to treat malignant iliac lymph node metastases. MATERIALS AND METHODS: In this retrospective study, 11 patients with a total of 11 iliac lymph node metastases were implanted with 125 I seeds (14.8-25.9 MBq) under CT-guidance, both the seed quantity and distribution were measured with a computerized treatment planning system. Treatment effects and adverse events were evaluated. RESULTS: 125 I seeds were successfully implanted in all patients, and the minimum peripheral dose of seeds was ranged from 30 to 110 Gy (median of 75 Gy). The median follow-up period was 11 months (ranged 3-39 months). Follow-up at 2 months after implantation revealed partial response in eight patients, stable disease in two patients, and progressive disease in one patient. The overall response rate and the local tumor control rate at 2 months were 72.73% and 90.91%, respectively. The rates of refractory pain and leg edema relief were 100% and 50% within 2 weeks after treatment, respectively. Survival rate at 1 year was 45.45%. No peri-interventional mortality or major complication was observed. CONCLUSION: 125 I seed implantation was a safe and effective technique for minimally invasive treatment for iliac lymph node malignant metastasis.

Case of unilateral leg swelling: a DVT mimic.

A 68-year-old woman with known metastatic renal cell carcinoma presented with an acutely swollen right leg. In between the two sessions of palliative radiotherapy to the right hip, she also had right hip modified Harrington procedure for tumour resection with hip replacement. Initial clinical evaluation raised the suspicion of right leg deep vein thrombosis (DVT). However, DVT was excluded and further investigations revealed stenosis of the right external and common iliac veins, likely secondary to radiotherapy.

Kissing stents for radiation-induced bilateral common iliac vein stenosis.

Radiation-induced venous stenosis is rare, with only a few cases reported in the literature. We report a case of radiation-induced venous stenosis of the bilateral iliac vein after radiation therapy for the treatment of recurrent bladder cancer. The patient was successfully treated using endovascular kissing stents.

Intraluminal Brachytherapy Using a Self-Expandable Stent Loaded With Linear Iodine-125 Seeds in a Patient With Reiterative Recurrence of Cancer-Associated Vein Obstruction: A Case Report With 3 Months of Follow-Up.

Cancer-associated vein obstruction (CAVO) is a common complication in oncological patients, but the effective therapeutic options are scant. We report a patient with reiterative recurrent CAVO who was successfully treated with intraluminal brachytherapy using a self-expandable stent loaded with linear radioactive iodine-125 seeds (RIS) strand. During follow-up, her clinical symptoms were well improved. Three-month imaging follow-up revealed satisfactory patency of the iliofemoral vein, and the stents combined with RIS strands performed well. No serious complications associated with the implantation of stent and RIS strands were documented in any of the sessions. Intraluminal brachytherapy using a self-expandable stent loaded with linear RIS may be a safe and effective option for CAVO as long as it includes not only blood flow restoration but also brachytherapy administration for cancer.

Role of endovascular stenting in radiation-induced stenosis of lower extremity veins.

Radiation-induced venous stenosis is rare with a few isolated cases reported in the medical literature involving the lower limb. Management options in such cases are thus not streamlined. We describe an unusual case of iliac vein stenosis in a patient with rectal carcinoma after combined chemoradiation therapy, managed with endovascular stenting. The possible mechanisms underlying the pathogenesis of venous stricture and their treatment options have been reviewed.

Irradiation of free vascularized tissue transplants in rats.

The aim of this experimental investigation was to show whether immediate irradiation of a free flap or an island flap is dangerous or not. The free epigastric flap of the rat was used as a model for this investigation. The patency of the epigastric vessels of the rat was not influenced by the irradiation and the histological findings showed no early reaction to the irradiation of the vessels of the transplanted tissue. The vessels of this experiment indicate that a free tissue transplantation is possible even if a combined radio-surgical treatment is planned.

Experimental microvascular anastomoses in radiated vessels: a study of the patency rate and the histopathology of healing.

A study of microvascular surgery in radiated tissue is presented. The radiation damage to the vessels and its consequence on the histopathology of blood vessel healing is discussed. The main difficulty encountered was the radiation-induced fibrosis in the perivascular tissues. The patency rate in ther arterial anastomoses was unaltered by prior radiation, but the patency rate in the venous anastomoses fell to 54 percent after high doses of prior radiation.