Endoscopic Ultrasonography-Guided Implantation of Iodine 125 Seeds in the Treatment of Unresectable Carcinoma of Pancreas

Abstract

Objective: To introduce the procedures and evaluate the clinic value of endoscopic ultrasonography-guided interstitial implantation of iodine 125 seeds in pancreatic cancer. Methods: Ten cases patients with pancreatic cancer underwent endoscopic ultrasonography-guided interstitial I seeds implantation. All patients were scanned on EUS, needle, and iodion seeds were used. The 125I seed was implanted with 19G needle and mick-gun during procedure. First of all, according to the size of tumor, the optimal quantity of seeds were calculated. Then, under the guidance of endoscopic ultrasonography, iodion seeds were implanted into the tumors for interstitial radiotherapy. CT follow-up examinations were performed one month after the therapy. The mean number of 125I seed ranged from 4 to 12 and the activity per seed ranged from 0.4 to 0.6mCi. Results: After procedure, relief of pain was obtained in 9 cases from 1 to 3 days. Patients were followed-up for 1 month, partial relief was obtained in 4 cases. In one case the pancreatic cancer decreased in size obviously (PR), in 6 cases the cancer size did not changed, 2 cases were progressive. Such complications as gastrointestinal tract bleeding, pancreatic fistula and pancreatitis were not found. Conclusion: Endoscopic ultrasonography-guided implantation of iodine 125 seeds in pancreatic cancer was a safe, reliable, and effective curative method for pancreatic cancer.