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Wu C, Cao B, He G, Li Y, Wang W. Stereotactic ablative brachytherapy versus percutaneous microwave ablation for early-stage non-small cell lung cancer: a multicenter retrospective study. BMC Cancer 2024; 24:304. [PMID: 38448897 PMCID: PMC10916219 DOI: 10.1186/s12885-024-12055-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND To analyze the efficacy of stereotactic ablative brachytherapy (SABT) and percutaneous microwave ablation (MWA) for the treatment of early-stage non-small cell lung cancer (NSCLC). METHODS Patients with early-stage (T1-T2aN0M0) NSCLC who underwent CT-guided SABT or MWA between October 2014 and March 2017 at four medical centers were retrospectively analyzed. Survival, treatment response, and procedure-related complications were assessed. RESULTS A total of 83 patients were included in this study. The median follow-up time was 55.2 months (range 7.2-76.8 months). The 1-, 3-, and 5-year overall survival (OS) rates were 96.4%, 82.3%, and 68.4% for the SABT group (n = 28), and 96.4%, 79.7%, and 63.2% for MWA group (n = 55), respectively. The 1-, 3-, and 5-year disease-free survival (DFS) rates were 92.9%, 74.6%, and 54.1% for SABT, and 92.7%, 70.5%, and 50.5% for MWA, respectively. There were no significant differences between SABT and MWA in terms of OS (p = 0.631) or DFS (p = 0.836). The recurrence rate was also similar between the two groups (p = 0.809). No procedure-related deaths occurred. Pneumothorax was the most common adverse event in the two groups, with no significant difference. No radiation pneumonia was found in the SABT group. CONCLUSIONS SABT provided similar efficacy to MWA for the treatment of stage I NSCLC. SABT may be a treatment option for unresectable early-stage NSCLC. However, future prospective randomized studies are required to verify these results.
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Affiliation(s)
- Chuanwang Wu
- Department of Interventional Medicine,The Second Hospital of Shandong University, Institute of Tumor Intervention,Cheeloo college of medicine, Shandong University, Jinan City, Shandong Province, China
- Department of Fifth Internal Medicine, People's Hospital of Shizhong District, No.156 Jiefang Road, Zaozhuang City, Shandong Province, China
| | - Binglong Cao
- Department of Oncology, Qufu Hospital of Traditional Chinese Medicine, No.129 Canggeng Road, Qufu City, Shandong Province, China
| | - Guanghui He
- Department of Interventional Medicine, Weifang Second People's Hospital, Weifang city, Shandong Province, China
| | - Yuliang Li
- Department of Interventional Medicine,The Second Hospital of Shandong University, Institute of Tumor Intervention,Cheeloo college of medicine, Shandong University, Jinan City, Shandong Province, China
| | - Wujie Wang
- Department of Interventional Medicine,The Second Hospital of Shandong University, Institute of Tumor Intervention,Cheeloo college of medicine, Shandong University, Jinan City, Shandong Province, China.
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2
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Wang R, Liu H, Antal B, Wolterbeek HT, Denkova AG. Ultrasmall Gold Nanoparticles Radiolabeled with Iodine-125 as Potential New Radiopharmaceutical. ACS APPLIED BIO MATERIALS 2024; 7:1240-1249. [PMID: 38323544 PMCID: PMC10880057 DOI: 10.1021/acsabm.3c01158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/08/2024]
Abstract
The relatively high linear energy transfer of Auger electrons, which can cause clustered DNA damage and hence efficient cell death, makes Auger emitters excellent candidates for attacking metastasized tumors. Moreover, gammas or positrons are usually emitted along with the Auger electrons, providing the possibility of theragnostic applications. Despite the promising properties of Auger electrons, only a few radiopharmaceuticals employing Auger emitters have been developed so far. This is most likely explained by the short ranges of these electrons, requiring the delivery of the Auger emitters to crucial cell parts such as the cell nucleus. In this work, we combined the Auger emitter 125I and ultrasmall gold nanoparticles to prepare a novel radiopharmaceutical. The 125I labeled gold nanoparticles were shown to accumulate at the cell nucleus, leading to a high tumor-killing efficiency in both 2D and 3D tumor cell models. The results from this work indicate that ultrasmall nanoparticles, which passively accumulate at the cell nucleus, have the potential to be applied in targeted radionuclide therapy. Even better tumor-killing efficiency can be expected if tumor-targeting moieties are conjugated to the nanoparticles.
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Affiliation(s)
- Runze Wang
- Applied
Radiation and Isotopes, Department of Radiation Science and Technology,
Faculty of Applied Sciences, Delft University
of Technology, Mekelweg 15, 2629 JB Delft, The Netherlands
| | - Huanhuan Liu
- Department
of Medical Imaging, Henan Provincial People’s
Hospital & the People’s Hospital of Zhengzhou University, Zhengzhou 450003, P. R. China
| | - Bas Antal
- Applied
Radiation and Isotopes, Department of Radiation Science and Technology,
Faculty of Applied Sciences, Delft University
of Technology, Mekelweg 15, 2629 JB Delft, The Netherlands
| | - Hubert Th. Wolterbeek
- Applied
Radiation and Isotopes, Department of Radiation Science and Technology,
Faculty of Applied Sciences, Delft University
of Technology, Mekelweg 15, 2629 JB Delft, The Netherlands
| | - Antonia G. Denkova
- Applied
Radiation and Isotopes, Department of Radiation Science and Technology,
Faculty of Applied Sciences, Delft University
of Technology, Mekelweg 15, 2629 JB Delft, The Netherlands
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3
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Chen X, Cao J, Zhang H, Liu R, Wang X. Topical photodynamic therapy for brachytherapy-induced oral mucositis. Photodiagnosis Photodyn Ther 2023:103617. [PMID: 37209763 DOI: 10.1016/j.pdpdt.2023.103617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/18/2023] [Accepted: 05/15/2023] [Indexed: 05/22/2023]
Abstract
In recent years, radioactive iodine-125 seed implantation has emerged as an effective treatment approach for locally advanced oral cancer. Nevertheless, some brachytherapy associated side reactions were reported, even at a relatively low initial radiation treatment volume. Radiogenic oral mucositis has been one of the most concerning side effects of this treatment method. Photodynamic therapy (PDT) is nowadays confirmed as a viable therapeutic strategy of oral mucositis. Herein, we report a case of 73-year-old male patient with ventral tongue and floor-of-the mouth cancer treated by iodine-125 implantation. Thereafter, this patient experienced radiation-induced oral mucositis. After being treated with four sessions of topical 5-aminolevulinic acid (ALA) PDT, this case was completely cured and followed up for 6-month with no recurrence.
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Affiliation(s)
- Xue Chen
- Department of Stomatology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Junnan Cao
- Department of Stomatology, Xuzhou First People's Hospital, Xuzhou, Jiangsu, China
| | - Hailong Zhang
- Department of Stomatology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China
| | - Rui Liu
- Department of Stomatology, Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China.
| | - Xing Wang
- Department of Stomatology, China Rehabilitation Research Center, Beijing, 100068, China.
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Li Y, Jiang Y, Wang J. Safety and efficacy of CT-guided radioactive iodine-125 seed implantation as a salvage treatment for recurrent head and neck cancer after two or more courses of radiotherapy. Radiat Oncol 2023; 18:73. [PMID: 37138362 PMCID: PMC10157907 DOI: 10.1186/s13014-023-02254-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 03/31/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND In the past, patients with recurrent head and neck cancer (rHNC) who had previously received a high dose of radiation and were unable to undergo surgery were mainly treated with palliative chemotherapy due to the high incidence of side effects from re-irradiation. With the development of radiotherapy technology, re-irradiation of recurrent lesions by radioactive iodine-125 seed implantation (RISI) has been proposed as a feasible therapeutic approach. This study aimed to investigate the safety and efficacy of computed tomography (CT)-guided RISI in the treatment of rHNC after two or more courses of radiotherapy, and to analyze the prognostic factors. METHODS Data of 33 patients with rHNC who received CT-guided RISI after two or more courses of radiotherapy were collected and statistically analyzed. The median cumulative dose of the previous radiotherapy was 110 Gy. Short-term efficacy was assessed by Response Evaluation Criteria in Solid Tumors (version 1.1) criteria, while adverse events were evaluated by Common Terminology Criteria for Adverse Events (version 5.0) criteria. RESULTS The median gross tumor volume (GTV) was 29.5 cc, and the postoperative median dose to 90% of target volume (D90) was 136.8 Gy. For adverse reactions, enhanced pain was found in 3 (9.1%) patients, followed by grade 1 to 2 acute skin reactions in 3 (9.1%) patients, grade 2 to 3 late skin reactions in 2 (6.1%) patients, grade 1 to 2 early mucosal reactions in 4 (12.1%) patients, and mandibular osteonecrosis in 1 (3.0%) patient. Regarding the treatment efficacy, the 1- and 2-year local control (LC) rates were 47.8% and 36.4% (median LC time, 10 months), and the 1- and 2-year overall survival (OS) rates were 41.3% and 32.2% (median OS time, 8 months). The absence of adverse events was associated with better LC. CONCLUSIONS CT-guided RISI, as a salvage therapy, demonstrated acceptable safety and efficacy in the treatment of rHNC after two or more courses of radiotherapy. TRIAL REGISTRATION This study was registered at Chinese Clinical Trial Register database (Registration No. ChiCTR2200063261 ) in September 2, 2022.
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Affiliation(s)
- Yue Li
- Department of Radiation Oncology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Yuliang Jiang
- Department of Radiation Oncology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, China.
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Zhang S, Chen S, Wang R, Wang Z, Zhou J, Li C. Clinical efficacy and safety analysis of CT-guided 125I implantation in the treatment of recurrent or metastatic pelvic malignant tumor. Brachytherapy 2023; 22:132-138. [PMID: 36586808 DOI: 10.1016/j.brachy.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 10/07/2022] [Accepted: 10/21/2022] [Indexed: 12/31/2022]
Abstract
PURPOSE This study was conducted to evaluate the clinical efficacy and safety of computed tomography (CT)-guided 125I implantation in the treatment of recurrent or metastatic pelvic malignant tumor. METHODS AND MATERIALS This retrospective study analyzed the data of 30 patients with recurrent and metastatic pelvic malignant tumor who were treated with CT-guided 125I implantation between January 2016 and December 2020. Disease control rate, objective remission rate, overall survival (OS), pain relief rate, quality of life score, and complications were evaluated after the followup. RESULTS Median followup was 20.1 (7-30) months. Disease control rate was 86.67% at 6 months. Objective response rates at 1, 3, and 6 months were 36.67%, 60%, and 56.67%, respectively. OS rates at 12 and 24 months were 76.67% (23/30) and 33.33% (10/30), respectively. Progression-free survival rates at 12 and 24 months were 63.33% (19/30) and 33.33% (10/30), respectively. Postoperative pain relief rate was 86.67% (26/30). There were no major bleeding, pelvic abscess, intestinal fistula, intestinal perforation, and other serious complications. CONCLUSIONS CT-guided 125I seed implantation in the treatment of patients with pelvic malignant tumor is a simple operation and less traumatic and can improve patients' quality of life and reduce tumor load.
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Affiliation(s)
- Shenghe Zhang
- Department of Intervention, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Songbai Chen
- Department of Intervention, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Ruoyu Wang
- Department of Medical Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.
| | - Zhe Wang
- Department of Medical Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Jun Zhou
- Department of Intervention, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Chuang Li
- Department of Intervention, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.
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Wang H, Shi HB, Qiang WG, Wang C, Sun B, Yuan Y, Hu WW. CT-guided Radioactive 125I Seed Implantation for Abdominal Incision Metastases of Colorectal Cancer: Safety and Efficacy in 17 Patients. Clin Colorectal Cancer 2023; 22:136-142. [PMID: 36463020 DOI: 10.1016/j.clcc.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION To retrospectively evaluate the safety and efficacy of computed tomography (CT)-guided iodine-125 (125I) seed implantation for patients with abdominal incision metastases from colorectal cancer. MATERIALS AND METHODS Data of patients with abdominal incision metastases of colorectal cancer from November 2010 to October 2020 were retrospectively reviewed. Each incisional metastasis was percutaneously treated with 125I seed implantation under CT guidance. Follow-up contrast-enhanced CT was reviewed, and the outcomes were evaluated in terms of objective response rate, complications, and overall survival. RESULTS A total of 17 patients were enrolled in this study. The median follow-up was 18 months (range, 2.7-22.1 months). At 3, 6, 12, and 18 months after the treatment, objective response rate was 52.9%, 63.6%, 33.3%, and 0%, respectively. A small amount of local hematoma occurred in two patients and resolved spontaneously without any treatment. Two patients experienced a minor displacement of radioactive seeds with no related symptoms. Severe complications, such as massive bleeding and radiation injury, were not observed. No ≥ grade 3 adverse events were identified. By the end of follow-up, 14 patients died of multiple hematogenous metastases. The one-year overall survival rate was 41.6%, and the median overall survival was 8.6 months. CONCLUSION CT-guided 125I seed implantation brachytherapy is safe and feasible for patients with abdominal incision metastases from colorectal cancer.
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Affiliation(s)
- Hao Wang
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Hong-Bing Shi
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Wei-Guang Qiang
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Chao Wang
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Bai Sun
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Ye Yuan
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Wen-Wei Hu
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China.
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7
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Li Y, Jiang Y, Qiu B, Sun H, Wang J. Current radiotherapy for recurrent head and neck cancer in the modern era: a state-of-the-art review. J Transl Med 2022; 20:566. [PMID: 36474246 PMCID: PMC9724430 DOI: 10.1186/s12967-022-03774-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In the management of head and neck cancer (HNC) patients, local recurrence is a common cause of treatment failure. Only a few patients with recurrent HNC (rHNC) are eligible for salvage surgery and the majority of patients receive systemic therapy and radiotherapy. In recent years, with the development of irradiation technology, radiotherapy for rHNC patients has markedly attracted clinicians' attention and its therapeutic effects on patients with end-stage cancer are worthy of investigation as well. METHODS Several studies have investigated the role of radiotherapy in the treatment of rHNC patients. We reviewed retrospective reports and prospective trials published in recent decades that concentrated on the management of rHNC. RESULTS A growing body of evidence supported the application of irradiation to rHNC patients. According to the results of this review, current radiotherapy could achieve a better efficacy with a lower incidence of toxicity. CONCLUSION Radiotherapy is a promising treatment for rHNC patients.
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Affiliation(s)
- Yue Li
- grid.411642.40000 0004 0605 3760Department of Radiation Oncology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 China
| | - Yuliang Jiang
- grid.411642.40000 0004 0605 3760Department of Radiation Oncology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 China
| | - Bin Qiu
- grid.411642.40000 0004 0605 3760Department of Radiation Oncology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 China
| | - Haitao Sun
- grid.411642.40000 0004 0605 3760Department of Radiation Oncology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 China
| | - Junjie Wang
- grid.411642.40000 0004 0605 3760Department of Radiation Oncology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191 China
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8
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Zhang M, Zhang J, Hu B, Huang L, Song S, Zhu H, Chen C, Chu C. The efficacy and safety of 125I brachytherapy combined with pre-operative transarterial chemoembolization in patients with locally advanced head and neck cancer. Front Oncol 2022; 12:992399. [PMID: 36185214 PMCID: PMC9515616 DOI: 10.3389/fonc.2022.992399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/23/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To evaluate the safety and effectiveness of Iodine-125 (125I) brachytherapy combined with pre-operative transarterial chemoembolization in patients with locally advanced head and neck cancer. Methods In this study, a total of thirty-seven individuals suffering from locally advanced head and neck cancer were involved. The patients were subjected to transarterial chemoembolization as well as implantation of 125I seeds under the guidance of CT and ultrasonography. Follow-up was conducted for 36 months to study the following parameters: the local control rate, survival rate, and clinical complications. Results In total, thirty-six patients at the end of three months showed an objective response rate of 69.8% and disease control rate of 93.0%, respectively. The 1, 2, and 3-year cumulative overall survival rate was 89.2%, 73.0%, and 45.9%, respectively. The adverse events of the treatment included infection (n=1, Grade III), radiation brachial plexus injury (n=1, Grade III), leukopenia (n=1, Grade III), cerebrovascular embolism (n=1, Grade IV). Conclusion The combination of 125I brachytherapy and pre-operative transarterial chemoembolization was safe and effective in patients with locally advanced head and neck cancer.
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Affiliation(s)
- Menglong Zhang
- Ganzhou People’s Hospital, Ganzhou, China
- *Correspondence: Menglong Zhang,
| | - Jian Zhang
- Ganzhou People’s Hospital, Ganzhou, China
| | - Bijuan Hu
- Ganzhou People’s Hospital, Ganzhou, China
| | | | | | - Haitao Zhu
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Chao Chen
- Ganzhou People’s Hospital, Ganzhou, China
| | - Cunkun Chu
- Library, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an, China
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Shen Z, Qu A, Jiang P, Jiang Y, Sun H, Wang J. Re-Irradiation for Recurrent Cervical Cancer: A State-of-the-Art Review. Curr Oncol 2022; 29:5262-5277. [PMID: 35892987 PMCID: PMC9331513 DOI: 10.3390/curroncol29080418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
The recurrence rate of cervical cancer after primary treatment can reach 60%, and a poor prognosis is reported in most cases. Treatment options for the recurrence of cervical cancer mainly depend on the prior treatment regimen and the location of recurrent lesions. Re-irradiation is still considered as a clinical challenge, owing to a high incidence of toxicity, especially in in-field recurrence within a short period of time. Recent advances in radiotherapy have preliminarily revealed encouraging outcomes of re-irradiation. Several centers have concentrasted on stereotactic body radiation therapy (SBRT) for the treatment of well-selected cases. Meanwhile, as the image-guiding techniques become more precise, a better dose profile can also be achieved in brachytherapy, including high-dose-rate interstitial brachytherapy (HDR-ISBT) and permanent radioactive seed implantation (PRSI). These treatment modalities have shown promising efficacy with a tolerable toxicity, providing further treatment options for recurrent cervical cancer. However, it is highly unlikely to draw a definite conclusion from all of those studies due to the large heterogeneity among them and the lack of large-scale prospective studies. This study mainly reviews and summarizes the progress of re-irradiation for recurrent cervical cancer in recent years, in order to provide potential treatment regimens for the management of re-irradiation.
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Feasibility of drug-eluting embolics chemoembolization for the management of recurrent/advanced head and neck cancer. J Vasc Interv Radiol 2022; 33:949-955. [PMID: 35569787 DOI: 10.1016/j.jvir.2022.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 04/23/2022] [Accepted: 05/04/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To characterize the safety, tolerability, and efficacy of chemoembolization with drug-eluting embolic (DEE) microspheres in patients with recurrent and advanced head and neck cancer. MATERIALS AND METHODS In this retrospective study, 32 patients (mean age, 57.2 ± 2.8 years; 17 women) with recurrent (n=16) and advanced (n=16) head and neck cancer were treated with chemoembolization with DEE microspheres loaded with doxorubicin. Treatment response, overall survival, local progression-free survival, and adverse events were evaluated. RESULTS At six months after the procedure, the objective response and disease control rates were 25% and 69%, respectively. The median overall survival and local progression-free survival were 14.5 and 13.6 months, respectively. Seven patients (22%) experienced adverse events after the chemoembolization procedure. All adverse events were related to post-embolization syndrome, including vomiting and nausea (n=1), pyrexia (n=2) and localized pain (n=7). No severe adverse events or procedure-related deaths were observed. CONCLUSION Chemoembolization with DEE microspheres was safe and tolerable in patients with recurrent and advanced head and neck cancer.
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11
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Chen L, Zhu GY, Jin ZC, Zhong BY, Wang Y, Lu J, Pan T, Teng GJ, Guo JH. Efficacy and Safety of Radioactive 125I Seed Implantation for Patients with Oligo-Recurrence Soft Tissue Sarcomas. Cardiovasc Intervent Radiol 2022; 45:808-813. [PMID: 35316381 DOI: 10.1007/s00270-022-03077-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/17/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the efficacy and safety of computed tomography-guided radioactive iodine-125 (125I) seed implantation for oligo-recurrence soft tissue sarcomas following surgical resection. MATERIALS AND METHODS Patients with oligo-recurrence soft tissue sarcomas after curative surgical resection between June 2013 and December 2020 were included. The primary outcome measure was objective response rate according to the Response Evaluation Criteria in Solid Tumors (RECIST 1.1). The secondary outcomes included progression-free survival, overall survival, and safety profiles. RESULTS Twenty-nine patients receiving computed tomography-guided 125I seed implantation were included in the study. The objective response rates at 2-, 6- and 12-month follow-up were 48.3%, 65.5% and 40.9%, respectively. The median progression-free survival was 11.3 months. The median overall survival was 25.1 months, with a 1- and 2-year overall survival rate of 81.5% and 50.0%, respectively. No severe treatment-related adverse effects occured. CONCLUSION 125I seed implantation has the potential to be an effective and safe treatment for oligo-recurrence soft tissue sarcomas after surgical resection.
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Affiliation(s)
- Li Chen
- Department of Radiology, Center of Interventional Radiology and Vascular Surgery, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China
| | - Guang-Yu Zhu
- Department of Radiology, Center of Interventional Radiology and Vascular Surgery, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China
| | - Zhi-Cheng Jin
- Department of Radiology, Center of Interventional Radiology and Vascular Surgery, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China
| | - Bin-Yan Zhong
- Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Yong Wang
- Department of Radiology, Center of Interventional Radiology and Vascular Surgery, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China
| | - Jian Lu
- Department of Radiology, Center of Interventional Radiology and Vascular Surgery, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China
| | - Tao Pan
- Department of Radiology, Center of Interventional Radiology and Vascular Surgery, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China
| | - Gao-Jun Teng
- Department of Radiology, Center of Interventional Radiology and Vascular Surgery, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China
| | - Jin-He Guo
- Department of Radiology, Center of Interventional Radiology and Vascular Surgery, Zhongda Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China.
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12
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Tiefenbach M, Schneider G, Riemann R, Symeou L, Bohr C, Lippert B. [Electrochemotherapy in oto-rhino-laryngology in Germany]. Laryngorhinootologie 2022; 101:195-205. [PMID: 35021242 DOI: 10.1055/a-1722-3252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Magnus Tiefenbach
- Hals-Nasen-Ohrenklinik, Am Gesundbrunnen 20-26, SLK-Kliniken, Heilbronn, Germany
| | | | | | - Luisa Symeou
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Regensburg, Regensburg, Germany
| | - Christopher Bohr
- Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Universitätsklinikum Regensburg, Regensburg, Germany
| | - Burkard Lippert
- Hals-Nasen-Ohrenklinik, Am Gesundbrunnen 20-26, SLK-Kliniken, Heilbronn, Germany
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Lentinan Combined with (125)I Brachytherapy for Recurrent Ovarian Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:2472444. [PMID: 34795781 PMCID: PMC8594994 DOI: 10.1155/2021/2472444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 10/16/2021] [Indexed: 12/03/2022]
Abstract
Objective To investigate the clinical value of lentinan combined with (125)I brachytherapy in the treatment of recurrent ovarian cancer. Methods A total of 160 patients with recurrent ovarian cancer admitted at Jiaozhou Central Hospital from June 2009 to October 2015 were enrolled in this study and randomly divided into observation group (80 cases) and control group (80 cases). The control group received chemotherapy. Observation group (80 cases) was treated with lentinan combined with (125)I brachytherapy on the basis of control group, and the efficacy, adverse reactions, and Karnofsky Performance Scale (KPS) and quality of life scale (QOL) scores of the two groups were analyzed and compared. Results After treatment, the levels of CA125, CA199, and CA724 in the 2 groups were markedly lower than those before treatment, and the observation group was lower than the control group (P < 0.05). After treatment, the proportion of CD4+/CD8+ cells and helper T cells and NK cells in the control group remarkably depleted, while the proportion of CD4+/CD8+ cells, NK cells, and B cells in the observation group increased significantly compared to that before treatment, and the level of IgA, IgG, and IgM in the control group decreased, while that in the observation group showed no conspicuous difference compared with that before chemotherapy (P > 0.05). The effective rate of observation group (85%) was higher than that of control group (75%) (P < 0.05). The overall survival of patients in the control group was (16.2 ± 2.04) months and that of the observation group was (24.8 ± 1.8) months. KPS and QOL scores in both groups were enormously higher than those before treatment, and the observation group was higher than the control group (P < 0.05). The incidence of hemoglobin reduction, leukopenia, aglobulia, granulocytopenia, nausea and vomiting, hepatorenal toxicity, and neurovirulence in the observation group was significantly lower than that in the control group. Conclusion Lentinan combined with (125)I brachytherapy is effective in treating recurrent ovarian cancer, with mild adverse reactions and good tolerance.
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Wei S, Li C, Li M, Xiong Y, Jiang Y, Sun H, Qiu B, Lin CJ, Wang J. Radioactive Iodine-125 in Tumor Therapy: Advances and Future Directions. Front Oncol 2021; 11:717180. [PMID: 34660280 PMCID: PMC8514864 DOI: 10.3389/fonc.2021.717180] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/07/2021] [Indexed: 12/11/2022] Open
Abstract
Radioactive iodine-125 (I-125) is the most widely used radioactive sealed source for interstitial permanent brachytherapy (BT). BT has the exceptional ability to deliver extremely high doses that external beam radiotherapy (EBRT) could never achieve within treated lesions, with the added benefit that doses drop off rapidly outside the target lesion by minimizing the exposure of uninvolved surrounding normal tissue. Spurred by multiple biological and technological advances, BT application has experienced substantial alteration over the past few decades. The procedure of I-125 radioactive seed implantation evolved from ultrasound guidance to computed tomography guidance. Compellingly, the creative introduction of 3D-printed individual templates, BT treatment planning systems, and artificial intelligence navigator systems remarkably increased the accuracy of I-125 BT and individualized I-125 ablative radiotherapy. Of note, utilizing I-125 to treat carcinoma in hollow cavity organs was enabled by the utility of self-expandable metal stents (SEMSs). Initially, I-125 BT was only used in the treatment of rare tumors. However, an increasing number of clinical trials upheld the efficacy and safety of I-125 BT in almost all tumors. Therefore, this study aims to summarize the recent advances of I-125 BT in cancer therapy, which cover experimental research to clinical investigations, including the development of novel techniques. This review also raises unanswered questions that may prompt future clinical trials and experimental work.
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Affiliation(s)
- Shuhua Wei
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Chunxiao Li
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Mengyuan Li
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Yan Xiong
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Yuliang Jiang
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Haitao Sun
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Bin Qiu
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | | | - Junjie Wang
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
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Han X, Fang S, Sheng R, Wang Y, Zhou J, Wang J. Dosimetry verification of three-dimensional printed polylactic acid template-guided precision 125 I seed implantation for lung cancer using a desktop three-dimensional printer. J Appl Clin Med Phys 2021; 22:202-209. [PMID: 34487634 PMCID: PMC8504606 DOI: 10.1002/acm2.13419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/16/2021] [Accepted: 08/23/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction The purpose of this study was to verify the effectiveness of polylactic acid (PLA) template puncture route planning by comparing preoperative and postoperative dosimetry using computerized tomography (CT)‐guided implantation of 125I radioactive seeds. Methods A total of 28 patients who underwent 125I seed implantation between January 2018 and June 2019 were selected for the statistical study of seed dosimetry. All patients received preoperative treatment planning system (TPS) planning, of which 13 patients in the experimental 3D template group underwent intraoperative puncture and implantation using the PLA template planning route. The other 15 patients in the traditional control group underwent intraoperative puncture and implantation using CT images for guidance. By calculating the dose‐volume histogram, preoperative and postoperative D90 values and postoperative V90 values were compared between the two groups. Results The mean D90 values in the template group before and after surgery were 136.06 ± 7.10 and 134.72 ± 7.85 Gy, respectively. There was no statistically significant difference. The preoperative and postoperative mean D90 values in the traditional group were 132.97 ± 8.04 and 126.06 ± 9.19 Gy, respectively, which were statistically significantly different. The mean postoperative V90 values in the template and traditional groups were 93.80 ± 1.34% and 88.42 ± 6.55 %, respectively, showing a statistically significant difference. Conclusions The preoperative TPS plan for the experimental group guided by the PLA template was almost the same as that for the final guided particle implantation. The dose parameters in the experimental group were also better than those in the traditional group, making the use of the presented PLA template more efficient for clinical applications.
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Affiliation(s)
- Xiaoyan Han
- Department of Geriatric Respiratory and Critical Care, Anhui Geriatric Institute, the First Affiliated Hospital of Anhui Medical University, Hefei City, China
| | - Shu Fang
- School of Biomedical Engineering, Anhui Medical University, Hefei City, China
| | - Rui Sheng
- Chaohu Clinical Medical College, Anhui Medical University, Chao Hu City, China
| | - Yi Wang
- School of Biomedical Engineering, Anhui Medical University, Hefei City, China
| | - Jinhua Zhou
- School of Biomedical Engineering, Anhui Medical University, Hefei City, China
| | - Jiong Wang
- Department of Geriatric Respiratory and Critical Care, Anhui Geriatric Institute, the First Affiliated Hospital of Anhui Medical University, Hefei City, China
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Chen Y, Dai J, Jiang Y, Ji Z, Jiang P, Sun H, Xu F, Wang J. Long-Term Outcomes of Personalized Stereotactic Ablative Brachytherapy for Recurrent Head and Neck Adenoid Cystic Carcinoma after Surgery or External Beam Radiotherapy: A 9-Year Study. J Pers Med 2021; 11:jpm11090839. [PMID: 34575616 PMCID: PMC8467951 DOI: 10.3390/jpm11090839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/21/2021] [Accepted: 08/22/2021] [Indexed: 12/12/2022] Open
Abstract
The management of recurrent head and neck adenoid cystic carcinoma (HNACC) remains a problematic challenge. This study aims to evaluate the long-term outcomes of personalized stereotactic ablative brachytherapy (SABT) as a salvage treatment for recurrent HNACC after surgery or external beam radiotherapy (EBRT). 21 patients with recurrent HNACC after surgery or EBRT successfully underwent iodine-125 (I-125) seed SABT from May 2011 to November 2019. The objective response rate (ORR), disease control rate (DCR), local control time (LCT), overall survival (OS), symptomatic relief and adverse events (AEs) were analyzed. Following SABT, the ORR and DCR were 85.7% and 100%, respectively. The 3-, and 5-year LCT rates were 68.8% and 55.1%, respectively, and the 3- and 5-year OS rates were 85.9% and 66.2%, respectively. Furthermore, univariate analyses showed that higher D90 (>137.1 Gy) was a strong positive prognostic factor of LCT (p < 0.05). The pain disappeared in one patient 3 months after SABT and partial pain improvement was observed in nine patients 1 to 6 months after SABT. Additionally, dyspnea was relieved in one patient with the tumor involving the trachea. The major AEs were mild intraoperative hemorrhage and skin/mucosal toxicities which were generally graded ≤2 and well-tolerated. Personalized SABT was an effective and safe alternative option for recurrent HNACC after the previous failure of surgery or EBRT. The parameter of D90 may influence the local control.
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Affiliation(s)
- Yi Chen
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Jinzhao Dai
- Department of Nuclear Medicine, Qingdao Central Hospital, Qingdao 266300, China;
| | - Yuliang Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Zhe Ji
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Haitao Sun
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Fei Xu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (Y.C.); (Y.J.); (Z.J.); (P.J.); (H.S.); (F.X.)
- Correspondence: ; Tel.: +86-137-0107-6310; Fax: +86-010-8226-5968
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American Brachytherapy Society (ABS) consensus statement for soft-tissue sarcoma brachytherapy. Brachytherapy 2021; 20:1200-1218. [PMID: 34303600 DOI: 10.1016/j.brachy.2021.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Growing data supports the role of radiation therapy in the treatment of soft tissue sarcoma (STS). Brachytherapy has been used for decades in the management of STS and can be utilized as monotherapy or as a boost to external beam radiation. We present updated guidelines from the American Brachytherapy Society regarding the utilization of brachytherapy in the management of STS. METHODS AND MATERIALS Members of the American Brachytherapy Society with expertise in STS and STS brachytherapy created an updated clinical practice guideline including step-by-step details for performing STS brachytherapy based on a literature review and clinical experience. RESULTS Brachytherapy monotherapy should be considered for lower-recurrence risk patients or after a local recurrence following previous external beam radiation; a brachytherapy boost can be considered in higher-risk patents meeting implant criteria. Multiple dose/fractionation regimens are available, with determination based on tumor location and treatment intent. Techniques to limit wound complications are based on the type of wound closure; wound complication can be mitigated with a delay in the start of brachytherapy with immediate wound closure or by utilizing a staged reconstruction technique, which allows an earlier treatment start with a delayed wound closure. CONCLUSIONS These updated guidelines provide clinicians with data on indications for STS brachytherapy as well as guidelines on how to perform and deliver high quality STS brachytherapy safely with minimal toxicity.
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Xue H, Qiu B, Wang H, Jiang P, Sukocheva O, Fan R, Xue L, Wang J. Stereotactic Ablative Brachytherapy: Recent Advances in Optimization of Radiobiological Cancer Therapy. Cancers (Basel) 2021; 13:cancers13143493. [PMID: 34298703 PMCID: PMC8304109 DOI: 10.3390/cancers13143493] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 02/07/2023] Open
Abstract
Brachytherapy (BT), a type of focal anti-cancer radiotherapy, delivers a highly focused radiation dose to localized tumors, sparing surrounding normal tissues. Recent technological advances have helped to increase the accuracy of BT and, thus, improve BT-based cancer treatment. Stereotactic ablative brachytherapy (SABT) was designed to improve the ablative effect of radiation, which was achieved via improved image guidance, and calculation of ablative dose, shorter treatment duration, and better organ preservation. Recently collected data characterized SABT as having the potential to cure various early-stage cancers. The method provides higher tumor control rate levels that were previously achievable only by surgical resection. Notably, SABT is suitable for application with unresectable malignancies. However, the pathological assessment of SABT irradiated tumors is limited due to difficulties in specimen acquisition. Prostate, lung, liver, and gynecological cancers are the most commonly reported SABT-treated malignancies. This study will give an overview of SABT, focusing on the advances in SABT optimization, and provide insights on the future benefits of the combined application of SABT with cancer immunotherapies.
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Affiliation(s)
- Hui Xue
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
| | - Bin Qiu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
| | - Hao Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
| | - Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
| | - Olga Sukocheva
- Discipline of Health Sciences, College of Nursing and Health Sciences, Flinders University of South Australia, Bedford Park, SA 5042, Australia;
| | - Ruitai Fan
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China;
| | - Lixiang Xue
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
- Correspondence: (L.X.); (J.W.); Tel.: +86-13701076310 (L.X.); +86-13701076310 (J.W.)
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China; (H.X.); (B.Q.); (H.W.); (P.J.)
- Correspondence: (L.X.); (J.W.); Tel.: +86-13701076310 (L.X.); +86-13701076310 (J.W.)
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19
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Jiang Y, Zhen P, Dai J, Li Y, Liu S, Xu J, Wang Y, Tian S, Cui Y, Ji Z, Guo F, Qiu B, Sun H, Fan J, Wang J. Long-Term Safety and Efficacy of CT-Guided I 125 Radioactive Seed Implantation as a Salvage Therapy for Recurrent Head and Neck Squamous Carcinoma: A Multicenter Retrospective Study. Front Oncol 2021; 11:645077. [PMID: 34277401 PMCID: PMC8281320 DOI: 10.3389/fonc.2021.645077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/18/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose To investigate the safety and efficacy of CT-guided I125 radioactive seed implantation (RSI) as a salvage therapy for recurrent head and neck squamous carcinoma (rHNSC) after external beam radiotherapy (EBRT) or surgery. Materials and Methods This is a multicenter retrospective study of 113 patients (83 males; median age 57 years) with rHNSC who underwent CT-guided I125 RSI between February 2003 and December 2017. Of the included patients, 107 patients previously received EBRT and 65 patients received surgery and all were ineligible or rejected for salvage surgery and/or repeat EBRT. Results During a median follow-up duration of 20 months (range, 3-152 months), 87 patients died. The 1-, 2-, 3-, and 5-year local control rate were 57.4%, 41.8%, 29.3%, and 15.2%, respectively. The median time to progression was 15 months [95% confidence interval (CI), 6.1-23.9 months]. The median overall survival (OS) was 20 months (95% CI, 12.4-27.6 months). The 1-, 2-, 3-, and 5-year OS rate were 63.6%, 44.6%, 29.9%, and 21.7%, respectively. Univariate and multivariate analyses revealed that KPS score and postoperative D90 were significantly associated with patients’ OS. The complications were mainly grade I/II skin and mucosal reactions: 18 cases (15.9%) of grade I/II and eight cases (7.0%) of grade III radiation dermatitis, and 14 cases (12.4%) of grade I/II and three cases (2.7%) grade III mucosal reactions. No grade IV or severer complications were found. Conclusion CT-guided I125 RSI may be safe as a salvage therapy for rHNSC after EBRT/surgery, yielding promising efficacy compared with historical data. KPS score and postoperative D90 may be significantly associated with OS.
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Affiliation(s)
- Yuliang Jiang
- Department of Radiation Oncology, Peking University 3rdHospital, Beijing, China
| | - Peng Zhen
- Department of Radiation Oncology, Chifeng Cancer Hospital, Chifeng, China
| | - Jinchao Dai
- Department of Nuclear Medicine, Qingdao Central Hospital, Qingdao, China
| | - Yixing Li
- Department of Nuclear Medicine, Yichang First People's Hospital, Yichang, China
| | - Shifeng Liu
- Department of Interventional Radiology, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Junma Xu
- Department of Respiratory, Jintan District People's Hospital, Changzhou, China
| | - Yufeng Wang
- Department of Nuclear Medicine, Xuzhou Cancer Hospital, Xuzhou, China
| | - Suqing Tian
- Department of Radiation Oncology, Peking University 3rdHospital, Beijing, China
| | - Yue Cui
- Department of Radiation Oncology, Peking University 3rdHospital, Beijing, China
| | - Zhe Ji
- Department of Radiation Oncology, Peking University 3rdHospital, Beijing, China
| | - Fuxin Guo
- Department of Radiation Oncology, Peking University 3rdHospital, Beijing, China
| | - Bin Qiu
- Department of Radiation Oncology, Peking University 3rdHospital, Beijing, China
| | - Haitao Sun
- Department of Radiation Oncology, Peking University 3rdHospital, Beijing, China
| | - Jinghong Fan
- Department of Radiation Oncology, Peking University 3rdHospital, Beijing, China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University 3rdHospital, Beijing, China
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20
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Qiu B, Jiang Y, Ji Z, Sun H, Fan J, Li W, Shao Y, Jiang P, Wang J. The Accuracy of Individualized 3D-Printing Template-Assisted I 125 Radioactive Seed Implantation for Recurrent/Metastatic Head and Neck Cancer. Front Oncol 2021; 11:664996. [PMID: 33869069 PMCID: PMC8045752 DOI: 10.3389/fonc.2021.664996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/12/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose To evaluate the accuracy of individualized 3D-printing template-assisted I125 radioactive seed implantation (3D-PT assisted I125 RSI) for recurrent/metastatic head and neck cancer. Materials and Methods From February 2017 to January 2020, clinical data of 41 patients (mean age, 58.5 ± 16.1 years; 28 males) with recurrent (48.8%)/metastatic (51.2%) head and neck cancer underwent individualized 3D-PT assisted I125 RSI under CT guidance in a single institute were retrospectively reviewed. Total 430 seed needles [mean, 10.5 (range 3–17) per patient] were inserted. Results All seed needles were inserted manually in a single attempt with the technical success rate of 100% without major perioperative complications. The mean needle’s entrance deviation was 0.090 cm (95% Confidence Interval, 0.081–0.098). The mean intraoperative depth and angle of the needle were consistent with that of planned (6.23 ± 0.24 vs. 6.21 ± 0.24 cm, p = 0.903; 83.14 ± 3.64 vs. 83.09 ± 3.66 degrees, p = 0.985, respectively). The mean deviation between the needle’s planned and intraoperative depth and angle was 0.168 ± 0.024 cm and 1.56 ± 0.14 degrees, respectively. The postoperative dosimetry parameters, including D90, D100, V100, V150, V200, conformity index, external index, and homogeneity index, were all well-coordinated with planned dosimetry without significant difference (p = 0.515, 0.662, 0.958, 0.865, 0.872, 0.278, 0.456, and 0.989, respectively). Conclusions Within the limitation of this study, individualized 3D-PT assisted I125 RSI may be accurate in obtaining favorable postoperative dosimetry for patients with recurrent/metastatic head and neck cancer. Clinical Trial Registration [website], identifier [registration number].
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Affiliation(s)
- Bin Qiu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.,Department of Radiation Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuliang Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Zhe Ji
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Haitao Sun
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Jinghong Fan
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Weiyan Li
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Yuxia Shao
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.,Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing, China
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21
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The effectiveness and prognostic factors of radioactive iodine-125 seed implantation for the treatment of cervical lymph node recurrence of esophageal squamous cell carcinoma after external beam radiation therapy. J Contemp Brachytherapy 2020; 12:579-585. [PMID: 33437306 PMCID: PMC7787212 DOI: 10.5114/jcb.2020.101691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/17/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To analyze factors influencing the efficacy of 125I seed implantation in the treatment of in-field cervical lymph node recurrence of esophageal squamous cell carcinoma (ESCC) after external beam radiation therapy. Material and methods We conducted a retrospective review of 36 patients with in-field cervical metastatic lymph nodes recurrence of esophageal squamous cell carcinoma (CML-ESCC) after external beam radiation therapy treatment, who underwent 125I seed implantation in our department from 2013 to 2019. Previous cumulative external irradiation dose ranged from 20 to 66 Gy (median, 60 Gy). The post-implant efficacy was evaluated by response evaluation criteria in solid tumors (RECIST) version 1.1, and an adverse event was evaluated by the Radiation Therapy Oncology Group (RTOG)/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Score (EORTC). COX proportional hazards model was used to analyze risk factors affecting effectiveness. Results Among 36 patients, 31 patients (86.1%) received fluorouracil-based chemotherapy (1-6 cycles) after 125I seed implantation. Local control rates at 3, 6, 12, and 24 months after implantation were 51%, 30%, 30%, and 18%, respectively, with a median of 9 months (95% CI: 6.106-11.894); survival rates after 3, 6, 12, and 24 months were 55%, 41%, 22%, and 22%, respectively, with a median of 8 months (95% CI: 5.753-10.247). Multivariate analysis showed that D90 and short-term efficacy were independent factors related to local control and survival rate (p = 0.005, < 0.001, 0.010, < 0.001). There were 2 cases (5.6%) with grade 1 skin toxicity, 1 case (2.8%) with grade 4 skin toxicity, 3 cases (8.3%) with grade 1 mucosal ulcer, and 3 cases (8.3%) with grade 1 xerostomia. Conclusions 125I seed implantation as an effective salvage treatment shows definite efficacy and safety for patients with in-field cervical lymph node recurrence of ESCC after external beam radiation therapy.
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22
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Zhao J, Zhi Z, Zhang H, Zhao J, Di Y, Xu K, Ma C, Liu Z, Sui A, Wang J. Efficacy and safety of CT-guided 125I brachytherapy in elderly patients with non-small cell lung cancer. Oncol Lett 2020; 20:183-192. [PMID: 32565946 PMCID: PMC7286004 DOI: 10.3892/ol.2020.11550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 03/20/2020] [Indexed: 12/25/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) has become the most common cancer type and the leading cause of cancer-associated mortality worldwide. The aim of the present retrospective study was to evaluate the efficacy and safety of computed tomography (CT)-guided 125I brachytherapy alone in elderly patients with NSCLC. A total of 26 elderly patients with NSCLC stage I–III who had an inoperable lesion or progressive disease following radio-chemotherapy were treated with CT-guided 125I seed implantation for lung lesions and included in the present study. The prescribed dose of 125I brachytherapy was 80–140 Gy, and dosimetric verification was performed immediately after the procedure. The response rate (RR) and local control rate (LCR) were analyzed according to the Response Evaluation Criteria in Solid Tumors (version 1.1). Survival was estimated using the Kaplan-Meier method. Safety and complications were also documented. All patients were aged 65–85 years (median age, 77 years) and successfully completed the procedure, and the median follow-up time was 9.4 months (range, 3–31 months). After a 6-month follow-up, for pulmonary lesions, complete response (CR) was achieved in 11 (42.3%) cases, partial response in 9 (34.6%) cases, stable disease in 4 (15.4%) cases and progressive disease in 2 (7.7%) cases. The 6-month RR and LCR were 76.9 (20/26) and 92.3% (24/26), respectively. The mean overall survival (OS) time was 11.7±7.6 months and the 0.5- and 1-year OS rates were 90.1 and 73.3%, respectively. Tumor-related symptoms in patients were significantly alleviated following the procedure. No severe complications occurred during and after the procedure of 125I seed implantation. In conclusion, CT-guided 125I brachytherapy is a feasible, effective and safe therapy and may be considered as an alternative option to surgery and radiotherapy for elderly patients with NSCLC.
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Affiliation(s)
- Jing Zhao
- Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Zheng Zhi
- Department of Basic Medicine, Hebei University of Chinese Medicine, Shijiazhuang, Hebei 050200, P.R. China
| | - Hongtao Zhang
- Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Jinxin Zhao
- Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Yan Di
- Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Ke Xu
- Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Chunling Ma
- Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Zezhou Liu
- Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Aixia Sui
- Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
| | - Juan Wang
- Department of Oncology, Hebei General Hospital, Shijiazhuang, Hebei 050051, P.R. China
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23
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Wang H, Lu J, Zheng XT, Zha JH, Jing WD, Wang Y, Zhu GY, Zeng CH, Chen L, Guo JH. Oligorecurrence Non-small Cell Lung Cancer After Failure of First-Line Chemotherapy: Computed Tomography-Guided 125I Seed Implantation vs. Second-Line Chemotherapy. Front Oncol 2020; 10:470. [PMID: 32373512 PMCID: PMC7179670 DOI: 10.3389/fonc.2020.00470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/16/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose: To compare the efficacy and safety of computed tomography (CT)–guided 125I seed implantation with second-line chemotherapy in treatment of oligorecurrence non–small cell lung cancer after failure of first-line chemotherapy. Methods: Data of oligorecurrence non–small cell lung cancer patients after failure of first-line chemotherapy at two institutions were retrospectively reviewed from January 2013 to July 2018. A total of 53 patients who received the treatment of 125I seed implantation or second-line chemotherapy were eligible for this study. In group A, 25 patients, 84 lesions, received CT-guided permanent 125I seed implantation, whereas in group B, 28 patients, 96 lesions, received second-line chemotherapy. The outcomes were measured in terms of disease control rate, overall survival, quality of life, and complications. Results: The median follow-up period was 13 months (range, 5–42 months). Disease control rate in group A was higher than that in group B (70.8 vs. 42.3%, P = 0.042) at 6 months after treatment. The median overall survival was 12.8 months (95% confidence interval, 10.5–15.1 months) in group A and 15.2 months (95% confidence interval, 12.2–18.2 months) in group B, with no significant difference (P = 0.847). Since the fourth month, the number of patients in group A with a non-decreasing Karnofsky Performance Scale score was more than that in group B (P < 0.05). The incidence of grade 3 or higher complications especially hematologic toxicity in group A was significantly lower than that in group B (P < 0.05). Conclusion: Radioactive 125I seed implantation is safe and feasible in selected non–small cell lung cancer patients with oligorecurrence after failure of first-line chemotherapy and seems to provide a better long-term quality of life in these patients compared with second-line chemotherapy.
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Affiliation(s)
- Hao Wang
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Jian Lu
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Xiao-Ting Zheng
- Center of Oncology, Tianchang City Hospital of Chinese Medicine, Chuzhou, China
| | - Jun-Hao Zha
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Wen-Dong Jing
- Center of Oncology, Tianchang City Hospital of Chinese Medicine, Chuzhou, China
| | - Yong Wang
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Guang-Yu Zhu
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Chu-Hui Zeng
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Lei Chen
- Department of Intervention and Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Jin-He Guo
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
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24
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Chen Y, Jiang Y, Ji Z, Jiang P, Xu F, Zhang Y, Zhang P, Guo F, Li X, Sun H, Lei R, Fan J, Li W, Huang Y, Wang J. Dosimetry, efficacy, and safety of three-dimensional printing noncoplanar template-assisted and CT-guided 125I seed implantation for recurrent retroperitoneal lymphatic metastasis after external beam radiotherapy. Brachytherapy 2020; 19:380-388. [PMID: 32249183 DOI: 10.1016/j.brachy.2020.02.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To evaluate the dosimetry, efficacy, and safety of radioactive 125I seed implantation (RISI) assisted by three-dimensional printing noncoplanar template (3D-PNCT) and CT for recurrent retroperitoneal lymphatic metastasis (RRLM) after previous external beam radiotherapy. METHODS AND MATERIALS From June 2016 to August 2018, 32 patients with RRLM successfully underwent 3D-PNCT-assisted and CT-guided RISI. The dosimetry, pain relief rate, performance improvement rate, overall response rate, disease control rate, local control time (LCT), overall survival (OS), and safety profiles were evaluated. RESULTS Dosimetric results showed that the D90, D100, V100, V150, V200, and homogeneity index were consistent in preoperation and postoperation (p > 0.05), except for the external index and conformal index (p = 0.048, p = 0.034). After RISI, 81.3% of the patients achieved pain relief, and 71.9% achieved an improvement of performance. The overall response rate and disease control rate were 85.3% and 94.1%, respectively. The LCT rates reached 66.2% and 43.2% in 1 year and two years, respectively, with a median LCT of 15.8 months. The OS rates were 74.1% and 28.1% in 1 year and two year, respectively, with a median OS reaching 17.6 months. Univariate analysis showed that when D90 > 130 Gy or D100 > 63 Gy or tumor size ≤49.8 cm3, LCT was extended significantly, but not for OS. Except for two patients developing Grade 1 retroperitoneal hematomas, no other severe adverse events were observed. CONCLUSIONS 3D-PNCT and CT guidance provide excellent accuracy for RISI, which can be an effective and safe alternative for RRLM after external beam radiotherapy. Radiation dose and tumor size seem to significantly influence the local control.
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Affiliation(s)
- Yi Chen
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Yuliang Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Zhe Ji
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Fei Xu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Yibao Zhang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing, China
| | - Pu Zhang
- Department of Radiation Oncology, Liaocheng People's Hospital, Liaocheng, Shandong Province, China
| | - Fuxing Guo
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Xuemin Li
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Haitao Sun
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Runhong Lei
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Jinghong Fan
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Weiyan Li
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Yuliang Huang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing, China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
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