Therapeutic effect of 125 I seed implantation under computed tomography guidance in treatment of recurrent or metastatic chest wall tumor:a preliminary study

Abstract

Objective To preliminarily evaluate the feasibility and therapeutic effect of 125 I seed implantation under computed tomography (CT) guidance in the treatment of recurrent or metastatic chest wall tumor.Methods A retrospective analysis was performed on the clinical data of 23 patients with recurrent or metastatic malignant chest wall tumor who underwent 125I seed implantation under CT guidance from July 2004 to October 2012.A computerized treatment planning system was used for three-dimensional treatment planning before operation to determine the number and spatial distribution of 125I seeds.CT scan dosimetry was performed immediately after operation.The dose received by 90％ of the target volume was 100-160 Gy (median:130 Gy).The activity of 125I seeds was (1.85-2.89) × 107 Bq (median:2.63 × 107 Bq).The total number of seeds implanted was 8-269 (median:53).The local control rate and survival rate were calculated by the Kaplan-Meier method.Results The follow-up rate was 100％.Two patients were followed up for at least 3 years,and 2 for at least 5 years.Of the 23 patients,4 had a complete remission,and 12 had a partial remission.The 1-,3-,and 5-year local control rates were 82％,62％,and 62％,respectively; the 1-,3-,and 5-year tumor-specific survival rates were 61％,45％,and 45％,respectively;the 1-,3-,and 5-year overall survival rates were 58％,58％,and 39％,respectively.After treatment,mild or moderate brachial plexus injury was seen in one patient,and grade 1 or 2 skin injury was seen in 6 patients.Conclusions 125I seed implantation under CT guidance is safe and effective in the treatment of recurrent or metastatic chest wall tumor,according to the preliminary study. Key words: Chest wall neoplasmsm; Neoplasms metastasis ; Neoplasms recurrence ; 125I seed implantation