Observation on short-term efficacy of thermal-therapy combined with 125I particles in treatment of recurrent rectal cancer

XI WANG; Jinhua HAN; Yunfeng LI; Yanming YANG

ABSTRACT

Objective:

To evaluate the clinical efficacy of thermal-therapy combined with 125 I radioactive particles by comparing the results of preoperative and postoperative images,serum carcino-embryonic antigen (CEA) and following-up after treatment of the patients with recurrent rectal cancer.

Methods:

Nineteen rectal cancer patients with postoperative recurrence after radiotherapy were treated with 125I implantation guided by CT (20 cases were treated with operation,but 1 patient was exited who couldn't tolerate the thermal-therapy).Radioactive particle treatment planning system (TPS) was used to make the plan before the particle implantation,and the distance of the particle was 1.0 cm;all patients received CT scanning and were quantificationally evaluatated after implantation;the number of seeded particles was about 12-58,the radioactivity of the 125I particle was 0.5 mCi,and the matching dose surrounding the tumor was 90-140 Gy.All patients were treated with microwave thermal-therapy after particle implantation,60 min per time,lasting the temprature at 43℃,twice per week,for three weeks.And the patients were followed up after treatment for 3 months,the efficacy was evaluated by image and CEA results,and the urinary frequency,dysuria,hematuria and rectal bleeding were evaluated.

Results:

Compred with before treatment,after following up for 6 months,the image results showed that the tumor volume was reduced,and the blood CEA level of all patients were decreased from (30.25±8.32) mg · L-1 to (11.89±5.22) mg · L-1 (t=13.158,P＜0.01);the local efficacy was 94.7％ (18/19),and the pain relief rate was 94.4％ (17/18);the NRS median was 6 (4,7) before treatment,and it was 1 (0,3) after treatment,there was significant difference (P＜0.001).There were no frequent urination,urinary pain,hematuria,rectal bleeding and other complications in all patients.

Conclusion:

Thermal-therapy combined with 125I radioactive particle implantation has good curative effects on the recurrent rectum cancer,and is effective means for recurrent rectum cancer treatment.