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Qiang W, Shi H, Sun B, Wang H, Wang C, Yuan Y, Hu W. Clinical efficacy and prognostic factors of CT-guided radioactive iodine-125 seed implantation for the treatment of superficial soft tissue metastasis: a 12-year retrospective analysis. Radiat Oncol 2024; 19:79. [PMID: 38915062 PMCID: PMC11194874 DOI: 10.1186/s13014-024-02475-w] [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: 10/02/2023] [Accepted: 06/17/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Superficial soft tissue metastasis (S-STM) of malignant tumors is uncommon and often brings great pain to patients. However, current treatment options are limited. The purpose of this study was to explore the clinical efficacy and prognostic factors of CT-guided radioactive iodine-125 (125I) seed implantation (RISI) for the treatment of S-STM. METHODS We retrospectively evaluated 132 patients with S-STM who received RISI between June 2010 and July 2022. Local tumor progression-free survival (ltPFS), tumor response, pain control and complication were analyzed. The independent factors affecting ltPFS were screened out using a layered Cox proportional hazards model. RESULTS The median follow-up time was 8.3 months (interquartile range [IQR], 4.5-15.3 months). The objective response rate (ORR) was 81.8%. The median ltPFS was 9.1 (95% CI: 6.6, 11.6) months. The Cox proportional hazard regression model revealed that the independent factors influencing ltPFS included KPS score, primary tumor, metastases, boundary, density and postoperative D90 (All P < 0.05). After RISI, the rate of pain relief was 92.3%. 66 (84.6%) patients reported pain marked relief, and 6 (7.7%) experienced pain moderate relief. No severe adverse events associated with RISI were observed during follow-up. CONCLUSIONS CT-guided RISI was associated with high local control and pain relief without severe adverse events and should be considered as a reliable palliative treatment modality for S-STM. TRIAL REGISTRATION Trial registration Retrospectively registered.
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Affiliation(s)
- Weiguang Qiang
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, People's Republic of China
| | - Hongbing Shi
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, People's Republic of China
| | - Bai Sun
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, People's Republic of China
| | - Hao Wang
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, People's Republic of China
| | - Chao Wang
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, People's Republic of China
| | - Ye Yuan
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, People's Republic of China
| | - Wenwei Hu
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, People's Republic of China.
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Cui TT, Guo XX, Li BR, Wang ZK, Xiao NJ, Liu F, Wang XD, Li W. The role of EUS-guided iodine-125 seed implantation in patients with unresectable ampullary cancer after relief of obstructive jaundice. J Contemp Brachytherapy 2024; 16:121-127. [PMID: 38808212 PMCID: PMC11129651 DOI: 10.5114/jcb.2024.139279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/09/2024] [Indexed: 05/30/2024] Open
Abstract
Purpose Few studies have focused on the management of inoperable ampullary carcinoma (AC), and patients with jaundice suffer from biliary stents replacement frequently. Iodine-125 (125I) brachytherapy has been used in the treatment of malignant tumors owing to its curative effect, minimal surgical trauma, and tolerable complications. The aim of the study was to investigate the role of 125I seed implantation in patients with unresectable ampullary carcinoma after relief of obstructive jaundice. Material and methods A total of 44 patients with obstructive jaundice resulting from unresectable ampullary carcinoma from January 1, 2010 to October 31, 2020 were enrolled in the study. Eleven patients underwent implantation of 125I seeds under endoscopic ultrasound (EUS) after receiving biliary stent placement via endoscopic retrograde cholangiopancreatography (ERCP) (treatment group), and 33 patients received a stent alone via ERCP (control group). Cox regression model was applied in this single-center retrospective comparison study. Results The median maximum intervention interval for biliary obstruction was 381 days (interquartile range [IQR]: 204-419 days) in the treatment group and 175 days (IQR: 126-274 days) in the control group (p < 0.05). Stent occlusion rates at 90 and 180 days in the control group were 12.9% and 51.6%, respectively. No stent occlusion occurred in the treatment group. Patients in the treatment group obtained longer survival time (median, 26 vs. 13 months; p < 0.01) and prolonged duodenal obstruction (median, 20.5 vs. 11 months; p < 0.05). No brachytherapy-related grade 3 or 4 adverse events were observed. Conclusions Longer intervention interval for biliary obstruction and survival as well as better stent patency and prolonged time to duodenal obstruction could be achieved by implanting 125I seeds combined with biliary stent in patients with unresectable ampullary cancer.
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Affiliation(s)
- Ting-ting Cui
- Department of Gastroenterology and Hepatology, Air Force Medical Center, Beijing, China
- Department of Gastroenterology and Hepatology, Medical School of Chinese PLA, Beijing, China
| | - Xin-xiang Guo
- Physical Examination Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Bai-rong Li
- Department of Gastroenterology and Hepatology, Air Force Medical Center, Beijing, China
| | - Zi-kai Wang
- Department of Gastroenterology and Hepatology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Nian-jun Xiao
- Department of Gastroenterology and Hepatology, Air Force Medical Center, Beijing, China
- Department of Gastroenterology and Hepatology, Medical School of Chinese PLA, Beijing, China
| | - Fang Liu
- Department of Gastroenterology and Hepatology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiang-dong Wang
- Department of Gastroenterology and Hepatology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wen Li
- Department of Gastroenterology and Hepatology, the First Medical Center, Chinese PLA General Hospital, Beijing, China
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Ji Z, Ni Y, He C, Huo B, Liu S, Ma Y, Song Y, Hu M, Zhang K, Wang Z, Zhao X, Han H, Wang Y, Wang R, Chai S, Hu X, Huang X, Ye X, Wang J. Clinical outcomes of radioactive seed brachytherapy and microwave ablation in inoperable stage I non-small cell lung cancer. Am J Cancer Res 2023; 13:3753-3762. [PMID: 37693146 PMCID: PMC10492108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/28/2023] [Indexed: 09/12/2023] Open
Abstract
This study assessed the efficacy and safety of radioactive iodine-125 seed ablation brachytherapy (RSABT) in comparison to microwave ablation therapy (MWAT) for treating inoperable stage I non-small cell lung cancer (NSCLC). We conducted a retrospective analysis of data from stage I NSCLC patients who underwent CT-guided RSABT or MWAT. The primary outcomes measured were progression-free survival (PFS), overall survival (OS), and the occurrence of adverse events. Of the patients included in the study, 71 underwent RSABT and 105 received MWAT. The median follow-up time for these groups was 47.4 months and 60 months, respectively. The PFS rates at 1-year, 3-year, and 5-year for the RSABT group were 87.3%, 72.6%, and 65.8%, while for the MWAT group, they were 89.5%, 69.3%, and 43.7%, respectively (P = 0.011). The OS rates at 1-year, 3-year, and 5-year for the RSABT group were 97.2%, 78.1%, and 66.1%, and for the MWAT group, they were 99%, 75.8%, and 55%, respectively (P = 0.112). Upon multivariate analysis, the treatment modality was identified as an independent predictor of PFS (P = 0.008). Additionally, both sex and T stage were found to be independent predictors of both PFS and OS (P < 0.05). Adverse events, such as pneumothorax, occurred in 50% of the MWAT group and 39% of the RSABT group (P = 0.313). The incidence of pleural effusion was 44% in the MWAT group compared to 14% in the RSABT group (P < 0.001). Needle bleeding was observed in 32% of the RSABT group and 5% of the MWAT group (P < 0.001). We conclude RSABT demonstrates promising efficacy and safety in the treatment of stage I NSCLC. However, further studies are essential to validate these preliminary findings.
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Affiliation(s)
- Zhe Ji
- Department of Radiation Oncology, Peking University Third HospitalBeijing, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Yang Ni
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan, Shandong, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Chuang He
- Department of Nuclear Medicine (Treatment Center of Minimally Invasive Intervention and Radioactive Particles), First Affiliated Hospital of The Army Medical UniversityChongqing, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Bin Huo
- Department of Thoracic Surgery and Oncology, The Second Hospital of Tianjin Medical UniversityTianjin, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Shifeng Liu
- Department of Intervention Therapy, The Affiliated Hospital of Qingdao UniversityQingdao, Shandong, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Yanli Ma
- Department of Oncology, Staff Hospital of Chengde Iron and Steel Group Co., Ltd.Chengde, Hebei, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Yuqing Song
- Department of Oncology, Staff Hospital of Chengde Iron and Steel Group Co., Ltd.Chengde, Hebei, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Miaomiao Hu
- Department of Oncology, Tengzhou Central People’s HospitalTengzhou, Shandong, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Kaixian Zhang
- Department of Oncology, Tengzhou Central People’s HospitalTengzhou, Shandong, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Zhe Wang
- Department of Radiation Oncology, Affiliated Zhongshan Hospital of Dalian UniversityDalian, Liaoning, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Xinxin Zhao
- Department of Oncology Radiotherapy, The First People’s Hospital of Kerqin DistrictTongliao, Inner Mongolia, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Hongmei Han
- Department of Oncology Radiotherapy, The First People’s Hospital of Kerqin DistrictTongliao, Inner Mongolia, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Yufeng Wang
- Department of Nuclear Medicine, Xuzhou Cancer HospitalXuzhou, Jiangsu, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Ruoyu Wang
- Department of Radiation Oncology, Affiliated Zhongshan Hospital of Dalian UniversityDalian, Liaoning, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Shude Chai
- Department of Nuclear Medicine (Treatment Center of Minimally Invasive Intervention and Radioactive Particles), First Affiliated Hospital of The Army Medical UniversityChongqing, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Xiaokun Hu
- Department of Intervention Therapy, The Affiliated Hospital of Qingdao UniversityQingdao, Shandong, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Xuequan Huang
- Department of Nuclear Medicine (Treatment Center of Minimally Invasive Intervention and Radioactive Particles), First Affiliated Hospital of The Army Medical UniversityChongqing, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Xin Ye
- Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan, Shandong, China
- China North Radioactive Brachytherapy Group (CNRBG)
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third HospitalBeijing, China
- China North Radioactive Brachytherapy Group (CNRBG)
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Yuan Q, Ma Y, Wu L, Song Y, He C, Huang X, Yang C, Liu B, Han H, Zhang K, Wang J. Clinical Outcome of CT-Guided Iodine-125 Radioactive Seed Implantation for Intrahepatic Recurrent Hepatocellular Carcinoma: A Retrospective, Multicenter Study. Front Oncol 2022; 12:819934. [PMID: 35463334 PMCID: PMC9024337 DOI: 10.3389/fonc.2022.819934] [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: 11/22/2021] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
Abstract
The efficacy and safety of CT-Guided Iodine-125 Radioactive Seed Implantation (RSI) for the treatment of intrahepatic recurrent hepatocellular carcinoma (rHCC) were analyzed in this multicenter retrospective study. We reviewed the medical records of patients with rHCC treated with I-125 seed implantation at four different hospitals in China from December 2011 and January 2021. The local progression-free survival (LPFS),liver PFS, and overall survival (OS) were calculated, and the short-term efficacy and treatment-related toxicities were evaluated. A total of 82 patients were enrolled; the median follow-up time was 46 months (range, 3–80 months). The 1-, 3- and 5-year LPFS rates were 63.8%, 27.1%, and 7.9%, respectively, and the corresponding OS rates were 74.8%, 32.9%, and 12.6%, respectively. Univariate analysis showed that factors influencing LPFS included the maximum lesion diameter, Barcelona Clinic Liver Cancer (BCLC) stage, interval between treatment and recurrence, and D90. Multivariate analyses revealed that the BCLC stage, interval between treatment and recurrence, and D90 were independent factors influencing LPFS, whereas BCLC stage, D90, and short-term efficacy were independent factors influencing OS. In summary, I-125 seed implantation is a safe and effective treatment for rHCC. The BCLC stage, interval, and D90 were found to influence the local control. A larger, prospective study is required to confirm the dose-response curve for Iodine-125 RSI of rHCC.
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Affiliation(s)
- Qianqian Yuan
- Department of Oncology, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Yanli Ma
- Department of Oncology, Staff Hospital of Chengde Iron and Steel Group Co. Ltd., Chengde, China
| | - Linlin Wu
- Department of Oncology, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Yuqing Song
- Department of Oncology, Staff Hospital of Chengde Iron and Steel Group Co. Ltd., Chengde, China
| | - Chuang He
- Department of Nuclear Medicine, Southwest Hospital, Army Medical University, Chongqing, China
| | - Xuequan Huang
- Department of Nuclear Medicine, Southwest Hospital, Army Medical University, Chongqing, China
| | - Chongshuang Yang
- Department of Nuclear Medicine, Southwest Hospital, Army Medical University, Chongqing, China
| | - Bin Liu
- Department of Surgery, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Hongmei Han
- Department of Radiation Oncology, The First People’s Hospital of Keerqin District, Tongliao, China
| | - Kaixian Zhang
- Department of Oncology, Tengzhou Central People’s Hospital, Zaozhuang, China
- *Correspondence: Kaixian Zhang, ; Junjie Wang,
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
- *Correspondence: Kaixian Zhang, ; Junjie Wang,
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Chen E, Zhang F, Jia C. Commentary: "Long-Term Outcomes and Prognostic Analysis of Computed Tomography-Guided Radioactive 125 I Seed Implantation for Locally Recurrent Rectal Cancer After External Beam Radiotherapy or Surgery": Letter to the Editor. Front Oncol 2021; 11:750922. [PMID: 34917505 PMCID: PMC8670938 DOI: 10.3389/fonc.2021.750922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/10/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Enli Chen
- Department of Oncology, Graduate School of Hebei Medical University, Hebei Medical University, Shijiazhuang, China
| | - Fenxian Zhang
- Department of Life Science, College of Life Science, Shanxi Agricultural University, Jinzhong, China
| | - Chenfei Jia
- Department of Oncology, Cangzhou Central Hospital, Cangzhou, China
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Jiang P, Zou L, Wei L, Cheng G, Sun B, Zhang F, Wang R, Wang T, Qu A, Yuan X, Qiu B, Wei S, Liu Z, Zhang Y, Wang J. Chinese Expert Consensus on Iodine 125 Seed Implantation for Recurrent Cervical Cancer in 2021. Front Oncol 2021; 11:700710. [PMID: 34858802 PMCID: PMC8630633 DOI: 10.3389/fonc.2021.700710] [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: 04/26/2021] [Accepted: 10/14/2021] [Indexed: 01/07/2023] Open
Abstract
The treatment modality for recurrent cervical cancer (rCC) is limited, and the prognosis of these patients is poor. Seed implantation could be an important component of rCC management in the context of dose boost or salvage therapy after surgery or radiotherapy, which is characterized by a minimally invasive, high local dose, and rapidly does fall, sparing normal tissue. For patients with good performance status and lateral pelvic wall recurrence with an available puncture path, seed implantation was recommended, as well as for selected central pelvic recurrence and extra-pelvic recurrence. The combination of brachytherapy treatment planning system and CT guidance was needed, and three-dimensional printing templates could greatly improve the accuracy, efficiency, and quality of seed implantation to achieve a potential ablative effect and provide an efficient treatment for rCC. However, the recommendations of seed implantation were mainly based on retrospective articles and lack high-quality evidence, and multicenter prospective randomized studies are needed. In this consensus on iodine125 seed implantation for rCC, indication selection, technical process and requirements, dosimetry criteria, radiation protection, combined systemic therapy, and outcomes of seed implantation for rCC are discussed.
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Affiliation(s)
- Ping Jiang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Lijuan Zou
- Department Radiation Oncology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lichun Wei
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Guanghui Cheng
- Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Baosheng Sun
- Department of Radiation Oncology, Jilin Cancer Hospital, Changchun, China
| | - Fuquan Zhang
- Department of Radiation Oncology, Peking Union Medical College Hospital, Beijing, China
| | - Ruoyu Wang
- Department of Radiation Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Tiejun Wang
- Department of Radiation Oncology, The Second Hospital of Jilin University, Changchun, China
| | - Ang Qu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Xiangkun Yuan
- Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine, Cangzhou, China
| | - Bin Qiu
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Shuhua Wei
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
| | - Zi Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xian, China
| | - Yunyan Zhang
- Department of Radiation Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
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PD-1 Inhibitor Maintenance Therapy Combined Iodine-125 Seed Implantation Successfully Salvage Recurrent Cervical Cancer after CCRT: A Case Report. Curr Oncol 2021; 28:4577-4586. [PMID: 34898560 PMCID: PMC8628734 DOI: 10.3390/curroncol28060387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/26/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022] Open
Abstract
Cervical cancer is the fourth most common cancer in females worldwide. Patients with stage III and IV cervical cancer based on the Federation of Gynecology and Obstetrics (FIGO) classification have higher recurrence rates. Because of organs at risk (OAR) protection and the low indication rate of salvage surgery, the choice of treatment is always challenging. Systemic chemotherapy is palliative and can be performed in conjunction with surgery or radiotherapy; however, it has no significant benefit to survival. Brachytherapy and stereotactic body radiotherapy (SBRT) are characterized by extremely high radiation doses applied to tumor cells while sparing the normal tissues. Several studies have investigated the efficacy of these technologies in recurrent cervical cancer and showed promising results. The immune checkpoint inhibitors approach was also investigated and showed promising results too. Herein, we report a case of a patient with cervical cancer that recurred five months after adjuvant chemotherapy and concurrent chemoradiotherapy. The disease prognosis after interstitial implantation brachytherapy (IIB) was determined. Then, the patient underwent radioactive 125I-seed implantation combined with PD-1 inhibitor treatment. The patient exhibited a partial response after seed implantation, and up to now, the duration of this partial response was 24 months.
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Shi H, Wang C, Qiang W, Sun B, Wang H, Yuan Y, Hu W. Case Report: Successful Control of Pulmonary Metastatic Pheochromocytoma With Iodine-125 Seed Implantation. Front Endocrinol (Lausanne) 2021; 12:714006. [PMID: 34434169 PMCID: PMC8380843 DOI: 10.3389/fendo.2021.714006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/22/2021] [Indexed: 11/20/2022] Open
Abstract
Pheochromocytoma with lung metastases is rare in clinics, and the prognosis of metastatic pheochromocytoma is generally poor. In this case, a 57-year-old woman who presented with hypertension and palpitations was diagnosed with left adrenal pheochromocytoma with lung metastasis in 2010. The patient received left adrenalectomy for pheochromocytoma 10 years ago, but pulmonary lesions had significant progression 7 years ago. The patient was treated with iodine-125 (125I) seed implantation for pulmonary lesions. All of the 5 pulmonary lesions achieved partial response 6 months later, further shrank 1 year later, and were successfully controlled for 7 years. This case indicated that 125I seed implantation could be an alternative local therapy for metastatic pheochromocytoma in the lung.
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