CT-Guided Radioactive 125I Seed Implantation Therapy of Symptomatic Retroperitoneal Lymph Node Metastases

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• 作者：Zhongmin Wang (1) (2)
  Jian Lu (2)
  Ju Gong (2)
  Liyun Zhang (2)
  Yingjia Xu (3)
  Shaoli Song (1)
  Kemin Chen (4)
  Fenju Liu (5)
  Huang Gang (1)
  
• 关键词：Retroperitoneal lymph node metastases ; CT ; guided ; Implantation ; 125I seed ; Brachytherapy
• 刊名：CardioVascular and Interventional Radiology
• 出版年：2014
• 出版时间：February 2014
• 年：2014
• 卷：37
• 期：1
• 页码：125-131
• 全文大小：280 KB
• 作者单位：Zhongmin Wang (1) (2)
  Jian Lu (2)
  Ju Gong (2)
  Liyun Zhang (2)
  Yingjia Xu (3)
  Shaoli Song (1)
  Kemin Chen (4)
  Fenju Liu (5)
  Huang Gang (1)
  
  1. Department of Nuclear Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, 1630 Dongfang Road, Shanghai, 200127, China
  2. Department of Radiology, Ruijin Hospital Luwan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, 200020, China
  3. Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China
  4. Department of Radiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
  5. School of Radiation Medicine and Public Health, Soochow University, Suzhou, 215123, China
  
• ISSN：1432-086X

文摘

Purpose This study explored the clinical efficacy of CT-guided radioactive 125I seed implantation in treating patients with symptomatic retroperitoneal lymph node metastases. Methods Twenty-five patients with pathologically confirmed malignant tumors received CT-guided radioactive 125I seed implantation to treat metastatic lymph nodes. The diameter of the metastatic lymph nodes ranged from 1.5 to 4.5?cm. Treatment planning system (TPS) was used to reconstruct the three-dimensional image of the tumor and then calculate the corresponding quantity and distribution of 125I seeds. Results Follow-up period for this group of patients was 2-0 months, and median time was 16?months. Symptoms of refractory pain were significantly resolved postimplantation (P?<?0.05), and Karnofsky score rose dramatically (P?<?0.05). Most patients reported pain relief 2-?days after treatment. Follow-up imaging studies were performed 2?months later, which revealed CR in 7 patients, PR in 13 patients, SD in 3 patients, and PD in 2 patients. The overall effective rate (CR?+?PR) was 80?%. Median survival time was 25.5?months. Seven patients died of recurrent tumor; 16 patients died of multiorgan failure or other metastases. Two patients survived after 30?months follow-up. Two patients reported localized skin erythema 1?week postimplantation, which disappeared after topical treatment. Conclusions CT-guided radioactive 125I seed implantation, which showed good palliative pain relief with acceptable short-term effects, has proved in our study to be a new, safe, effective, and relatively uncomplicated treatment option for symptomatic retroperitoneal metastatic lymph nodes.