CT-guided implantation of ¹²⁵I seeds (permanent brachytherapy) for metastatic tumors of the hepatic portal system: Effectiveness and safety in 13 patients

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• 作者：Jie Li¹ ; ² ; Qigen Xie² ; Weiguo Wang² ; Yanyan Hua² ; Yun Cheng² ; Ling Li² ; Xiaoli Zhu¹ ; ^{759853297@qq.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Brachytherapy ; Iodine-125 ; Computed tomography guided ; Metastasis tumor ; Portal hepatic
• 刊名：Brachytherapy
• 出版年：2016
• 出版时间：March-April 2016
• 年：2016
• 卷：15
• 期：2
• 页码：224-230
• 全文大小：1219 K

文摘

To retrospectively evaluate the efficacy and safety of CT-guided implantation of ¹²⁵I seeds (permanent brachytherapy) for metastatic tumors of the hepatic portal system (HPS).

Methods and Materials

Between January 2012 and January 2015, 13 patients with metastases measuring >3.0 cm in short-axis diameter, which remained in the HPS after conventional chemotherapy and/or transcatheter arterial chemoembolization, and for which an effective therapeutic dose from external beam radiotherapy could not be delivered, received CT-guided ¹²⁵I brachytherapy. Clinical data were studied retrospectively. In terms of metrological requirements, the minimum dose to 90% of the target volume (D₉₀) was 90–160 Gy for ¹²⁵I seeds with activity of 2.96 × 10⁷Bq. CT-based evaluation after 2, 4, and 8 weeks, as well as 6 months after implantation enabled review of local control of tumors.

Results

All symptoms were improved after ¹²⁵I brachytherapy. The mean value for D₉₀ for implantation of ¹²⁵I seeds was 136 Gy. Complete response (CR) + partial response (PR) was documented in 61.5%, 69.2%, and 84.6% of patients at 2 weeks, 4 weeks, and 6 months after implantation, respectively. Four of 13 patients had complete response, 7 cases had PR, 1 patient had stable disease, and 1 case had progressive disease. All metastatic foci were controlled by implantation. No serious complications were observed.

Conclusion

CT-guided ¹²⁵I brachytherapy is a safe and effective treatment for metastatic tumors of the HPS and can achieve good local control in the short term as long as the radiation dose is sufficient. CT-guided ¹²⁵I brachytherapy carries few complications, is simple, safe, and a good complement to cancer treatment.