Treatment of unresectable advanced gastric cancer using lodine-125 brachytherapy

Abstract

OBJECTIVE The purpose of the study was to examine the efficacy of treating patients with advanced gastric cancer using iodine - 125 (125I) brachytherapy. METHODS Ten patients with unresectable advanced gastric cancer were selected based on their pattern of CT scans. We utilized a brachytherapy planning system to determine the distribution of the 125I seeds, their activity and quantity. The matched peripheral dose (MPD) was 110–135 Gy. 125I seeds were implanted in a single plane or biplane by an intraoperative small incision or percutaneous puncture. The postoperative hemogram, CT, KPS, pain-relieving period and survival period were recorded. RESULTS One patient developed a complete response (CR), 4 patients a partial response (PR), 3 patients showed no change (NC) and 2 patients developed progressive disease (PD). The overall response rate (CR+PR) was 50% (5/10). The pain-relieving rate was 89% (8/9). The patients’ appetite and KPS were improved. The longest survival period was 10 months and median life span was 4 months. There were 8 patients whose seeds fell off resulting in an expulsion rate of 3.8% (26/692). The patients showed 0–1 degree acute radio-therapeutic side-effects without other symptoms such as abdominal pain, vomitus cruentes or intestinal obstruction etc. CONCLUSION Applying 125I implantation to treat advanced gastric cancer with a reasonable seed distribution can significantly improve clinical symptoms and their quality of life. The radioactive damage is mild. This method can be used as an important supplementary treatment for unresectable advanced gastric cancer.