125I Seed Implantation In Treatment Research Articles

Circular RNA circEYA3 promotes the radiation resistance of hepatocellular carcinoma via the IGF2BP2/DTX3L axis

BackgroundHepatocellular carcinoma (HCC) has a high incidence and mortality rate despite various treatment options, including 125I seed implantation. However, recurrence and radiation resistance remain challenging issues. Hsa_circ_0007895 (circEYA3)—derived from exons 2–6 of EYA3–facilitates the proliferation and progression of pancreatic ductal adenocarcinoma. However, the role of circEYA3 in HCC 125I radiation resistance remains unclear. Thus, we aimed to investigate the functions and underlying molecular mechanisms of circEYA3 in HCC under 125I and X-ray irradiation conditions.MethodsCircEYA3 was identified by RNA-seq in patients with HCC before and after 125I seed implantation treatment, followed by fluorescence in situ hybridization and RNase R assays. The radiosensitivity of HCC cell lines irradiated with 125I seeds or external irradiation were evaluated using the Cell Counting Kit 8, flow cytometry, γH2A.X immunofluorescence and comet assays. RNA pull-down and RNA immunoprecipitation assays were performed to explore the interactions between circEYA3 and IGF2BP2. DTX3L mRNA was identified by RNA-seq in PLC/PRF/5 cells with overexpressed circEYA3. The corresponding in vitro results were verified using a mouse xenograft model.ResultsCircEYA3 decreased the radiosensitivity of HCC cells both in vitro and in vivo. Notably, using a circRNA pulldown assay and RNA-binding protein immunoprecipitation, we identified IGF2BP2 as a novel and robust interacting protein of circEYA3. Mechanistically, circEYA3 binds to IGF2BP2 and enhances its ability to stabilize DTX3L mRNA, thereby specifically alleviating radiation-induced DNA damage in HCC cells.ConclusionsOur findings demonstrate that circEYA3 increases the radioresistance of HCC to 125I seeds and external irradiation via the IGF2BP2/DTX3L axis. Thus, circEYA3 might be a predictive indicator and intervention option for 125I brachytherapy or external radiotherapy in HCC.

To evaluate the efficacy and safety of 125I seed implantation in SCLC as second line therapy.

This study aimed to evaluate the efficacy and safety of iodine 125 (125I) radioactive seed implantation for small cell lung cancer at the limited stage of relapse as second line therapy. We collected 6 patients with recurred limited stage small cell lung cancer, who got pathological diagnosis after a bronchoscopic biopsy and then received standard first line treatment, combined chemotherapy and radiotherapy, including prophylactic cranial irradiation. These recurred small cell lung cancer patients got 125I seed implantation treatment as second line therapy, if the treatment not good responsive or the disease got rapid progress, we used the second line chemotherapy as salvage treatment. Clinical data of these patients were collected and short-term effects were observed. The follow-up period lasted for 42 months. All the patients tolerated the procedure of 125I radioactive seed implantation very well. We followed up the patients to 42 months. Five patients got complete remission and 1 patient got partial remission at 1 month after implantation. The objective response rate was 100%. The median survival time was 26 months. And median progression-free survival was 12 months after 125I treatment. And about the complications, 1 patient suffered from the light aerothorax, 1 patient had a little hemoptysis. Our study showed that 125I seed implantation as second line regimen in small cell lung cancer that recurred locally after first line treatment was effective and safe. That could improve the overall survival and progression-free survival only comparing to the second line chemotherapy. Therefore 125I seed implantation as brachytherapy protocol is a promising method and can be applied as second line treatment to control the locally recurred small cell lung cancer.

Efficacy and clinical prognostic factors of image-guided 125I seed implantation for locally recurrent soft tissue sarcoma

Objective To evaluate the outcomes and prognostic factors of image-guided 125I seed implantation for locally recurrent soft tissue sarcoma(RSTS). Methods A total of 60 patients with RSTS who received image-guided 125I seed implantation in Peking University Third Hospital, from September 2002 to December 2015, were retrospectively analyzed. The enrollment criteria: KPS > 60 points, refused or could not tolerate surgery or radiotherapy, the expecting survival time >3 months, relapsed after multiple treatment of soft tissue sarcoma, and underwent CT or ultrasound guided 125I seed implantation treatment. In all, the median activity of seeds was 25.9×106 Bq (range, 11.1×106-29.6×106 Bq), median number of implanted seeds was 58 (range, 3-133), and the median D90 was 120 Gy (range, 36.50-460.97 Gy). The local progression-free survival (LPFS) and overall survival (OS) were calculated using the Kaplan-Meier method . The log-rank test and Cox regression model were used for the univariate and multivariate analyses. Results The median follow-up was 18.75 months (range, 1-146). The median OS was 18.5 months (95% CI 13.1-23.9). The 1-, 3- and 5-year OS rate were 63.3%, 33.0% and 29.5%, respectively. The 1-, 3- and 5-year LPFS rate were 72.5%, 63.7% and 59.7%, respectively. The general rate of pain relieving was 100% (6/6). 8.3% (5/60) presented grade Ⅳ skin toxicity. No fatal complications ocurred. The univariate analysis suggested that tumor size, tumor volume, KPS score, D90 were prognostic factors of OS and LPFS. The multivariate analysis demonstrated that previous chemotherapy history and distant metastases were independent prognostic factors of survival. Conclusions Image-guided 125I seed implantation for recurrent soft tissue sarcoma is a safe treatment option with high efficacy and low morbidity. Tumor size and D90 were the prognostic factors of OS and LPFS. Key words: Recurrence; Soft tissue sarcoma; 125I seed implantation; Prognosis

Clinical value of 125I seeds implantation in treatment of lymph nodes metastases from 131I refractory differentiated thyroid carcinoma

Objective To evaluate the clinical value of 125I seeds implantation (RSI) for treatment of lymph nodes metastases (LNM) in patients with 131I refractory differentiated thyroid carcinoma (RAIR-DTC). Methods A total of 42 RAIR-DTC patients with LNM (14 males, 28 females, median age 49 years) who underwent RSI guided by CT from January 2015 to June 2016 were retrospectively analyzed. All patients underwent CT and their serum thyroglobulin (Tg) levels were measured 2, 4 and 6 months post-treatment. The LNM size and serum Tg levels before and after treatment were compared, and the curative effect of RSI for complications was observed. Paired t test, χ2 test, repeated measurement analysis of variance, Spearman correlation analysis were used to analyze the data. Results Two patients (4.76%) achieved complete remission, 9(21.43%) achieved partial remission, 29(69.05%) had no change, 2(4.76%) were with progressive disease in all 42 patients. The total effective rate was 95.24%(40/42). The LNM diameter post-treatment was (1.39±0.75) cm, significantly lower than that before treatment ((1.99±0.38) cm; t=5.557, P 0.05). The LNM size was the influencing factor on RSI (χ2=4.524, P<0.05). Conclusions 125I RSI can significantly alleviate the clinical symptoms of RAIR-DTC patients with LNM, and the LNM size has relevance for the treatment effect. The clinical follow-up time of serum Tg level can be extended to 6 months or even longer. Key words: Thyroid neoplasms; Neoplasm metastasis; Lymph nodes; Brachytherapy; Iodine radioisotopes

Efficacy analysis of chemotherapy in combination with 125I seed implantation for treatment of inoperational pancoast tumor

Objective To explore the therapeutic effect of radioactive 125I seeds combined with chemotherapy on the treatment of inoperative pancoast tumor by CT-guided percutaneous implantation of treatment planning system (TPS). Methods From December 2002 to December 2010, 36 patients with pancoast tumor were confirmed by imaging and pathology. Among them, 26 cases suffered from squamous cell carcinoma and 10 cases with adenocarcinoma. At 1 week after radioactive 125I implantation, chemotherapy was administered as intravenous 1 000 mg / m2 gemcitabine at 1 and 8 d and intravenous cisplatin 75 mg / m2 at 1 d for 4 consecutive cycles. The prescribed dose (PD) was 120 Gy, and the median activity of the seeds was 0.7 mCi(2.59×107 Bq)with the range of 0.68-0.82 mCi (2.52×107-3.03×107 Bq). The patients were followed-up and the median follow-up time was 48 months. The survival rate was observed. Results The mPD of the target tumor was (118.7± 7.2) Gy, D90 (126± 4.7) Gy, D90> mPD. The rate of CR (11 cases) was 63.6%, and the effective rate (CR+ PR) was 83.4%. The follow-up last till December 1st, 2016. 1-, 3-and 5-year local control rates were 92%, 83%, and 67%, respectively. 1-, 3-and 5-year cumulative survival rate were 84.1%, 56.7%, and 36.8%, respectively. Median survival was 38 months. Conclusions Chemotherapy combined with tissue radioactive 125I seed implantation is a minimally invasive and effective method for the treatment of pancoast tumor. Key words: 125I; Brachytherapy; Pancoast tumor; Efficacy

Dosimetric study of 3D-printing coplanar template combined with CT-guided 125I seed implantation for treating non-small cell lung cancer

Objective To explore the safety, effectivity and dosimetric continence of 3D-printing coplanar template(3D-PCT)combined with CT-guided 125I seed implantation in the treatment of non-small cell lung cancer(NSCLC). Methods From May 2014 to November 2016, a total of 20 NSCLC patients who were suitable for 125I seed implantation were recruited in this study. Of all the patients, 10 received 125I seed implantation treatment by CT-guided combined with 3D-PCT (3D group), and the rest, by free-hand puncture combined with CT-guided 125I seed implantation (free-hand group). During two days before the surgery, the patients received the CT scan. Then the digital imaging and communications in medicine(DICOM) was collected to input to the Brachytherapy Treatment Planning System(BTPS). The dose parameters including D90, D100, V100, V150, conformal index(CI), external index(EI), and homogneneity index(HI) were compared between pre-operation and post-operation. Pair t-test and single sample t-test were performed. Results V150 in 3D group between preoperation and postoperation showed statistically significant difference(t=-2.916, P 0.05). However, the number of seeds, V100, EI, HI in free-hand group between preoperation and postoperation showed statistically significant difference(t=-2.516, 2.492, 4.725, 7.258, P 0.05). Comparison of indicuted that there was significant difference in V100, V150, CI, EI, HI and dose error rate between the 3D group and the free-hand group with single sample t test, the result showed V100, CI, EI, HI between two groups(t=2.598, 2.278, 4.637, 4.616, -4.785, P 0.05). Conclusions CT-guided 125I seed implantation brachytherapy combined with 3D-PCT for treatment of NSCLC safe is feasible, and dose controllable, and there is a certain advantage in the spatial distribution of seed compared with free-hand puncture. Key words: 3D-printing; Coplanar template; Free hand; 125I seed implantation; Non small cell lung cancer

Preliminary Clinical Study in Open MRI-Guided 125I Seed Implantation for Treatment of Brain Tumor

To investigate the feasibility and effectiveness of open magnetic resonance imaging (MRI) guided 125I seed implantation for the treatment of brain gliomas and metastatic tumors.

Preliminary Investigation of CT-Guided 125I Seed Implantation Treatment Efficacy in Patients with Large Iliac Lymph Nodes Metastases

Preliminary Investigation of CT-Guided 125I Seed Implantation Treatment Efficacy in Patients with Large Iliac Lymph Nodes Metastases

Safety and effectiveness of modified radioactive iodine-125 seed implantation in treatment of lung cancer patients with poor lung function

Objective To study the safety and effectiveness of modified radioactive 125I seed implantation in treatment of lung cancer patients with poor lung function. Methods Thirty one lung cancer patients with poor lung function were enrolled into this study. All of them were implanted 125I seed with technology of fan-shaped distribution and coaxial puncture. Brachytherapy planning system(TPS) was used to draw up a preoperative implantation plan. Fan-shaped seed distribution system was used to simulate surgical program, and implantation pitch was 0.5 to 1.0 cm. Real-time adjustment is necessary during surgery. Dose distributions were checked by TPS immediately after implantation. Match peripheral dose(MPD),the dose of 90% tumor volume (D90) and the tumor volume covered by 90% prescription dose (D90) were calculated. Intraoperative and postoperative surgery-related complications were analyzed. All patients were followed up to 6 months, at month 2, 4 and 6 post-procedure, CT scan was performed to evaluate the local control rate of tumors. Results The technical success rate was 100% for placement of the 125I seed. MPD of the tumors was 90 to 140 Gy. D90 was 95 to 146 Gy,median dose was 118 Gy.V90 was 92% to 97%,median dose was 94%. Surgery-related complications included pulmonary hemorrhage(1 patient), pleural cavity hemorrhage (2 patients), pneumothorax(2 patients). The 2-month, 4-month and 6-monthlocal control rates were 31% (10/32), 78%(25/32) and 90% (29/32)respectively. The overall complete remission(CR) rate was 18%(6/32), partial response(PR) rate was 72% (23/32), stable disease(SD)rate was6% (2/32), progression disease(PD) rate was 3% (1/32).Acute radiation pneumonitis Grade 0 in 29 patients, Grade Ⅰ in 4 patients; advanced radiation pneumonitis: grade 0 in 30 patients and grade Ⅰ in 3 patients. Conclusions The technology of fan-shaped distribution and coaxial puncture for radioactive 125I seed implantation was safe and effective to treat lung cancer patients with poor lung function. Key words: Lung neoplasms; Radiology,interventional; Brachy therapy; Interstitial irradiation

Current status and future perspectives of interstitial 125I seed implantation treatment for malignant tumors

放射性粒子组织间植入治疗恶性肿瘤属内放疗范畴，是通过超声或CT引导定位技术和治疗计划系统（treatmentplanningsystem，TPS），将带有放射线的微粒植入到肿瘤组织间，或瘤床，或淋巴引流区域，达到治疗恶性肿瘤的目的。目前，国内外应用最多的放射性粒子为^125I，因其便于保存和防护，

Continuous and low-energy 125I seed irradiation changes DNA methyltransferases expression patterns and inhibits pancreatic cancer tumor growth

BackgroundIodine 125 (125I) seed irradiation is an effective treatment for unresectable pancreatic cancers. However, the radiobiological mechanisms underlying brachytherapy remain unclear. Therefore, we investigated the influence of continuous and low-energy 125I irradiation on apoptosis, expression of DNA methyltransferases (DNMTs) and cell growth in pancreatic cancers.Materials and methodsFor in vitro 125I seed irradiation, SW-1990 cells were divided into three groups: control (0 Gy), 2 Gy, and 4 Gy. To create an animal model of pancreatic cancer, the SW 1990 cells were surgically implanted into the mouse pancreas. At 10 d post-implantation, the 30 mice with pancreatic cancer underwent 125I seed implantation and were separated into three groups: 0 Gy, 2 Gy, and 4 Gy group. At 48 or 72 h after irradiation, apoptosis was detected by flow cytometry; changes in DNMTs mRNA and protein expression were assessed by real-time PCR and western blotting analysis, respectively. At 28 d after 125I seed implantation, in vivo apoptosis was evaluated with TUNEL staining, while DNMTs protein expression was detected with immunohistochemical staining. The tumor volume was measured 0 and 28 d after 125I seed implantation.Results125I seed irradiation induced significant apoptosis, especially at 4 Gy. DNMT1 and DNMT3b mRNA and protein expression were substantially higher in the 2 Gy group than in the control group. Conversely, the 4 Gy cell group exhibited significantly decreased DNMT3b mRNA and protein expression relative to the control group. There were substantially more TUNEL positive in the 125I seed implantation treatment group than in the control group, especially at 4 Gy. The 4 Gy seed implantation group showed weaker staining for DNMT1 and DNMT3b protein relative to the control group. Consequently, 125I seed implantation inhibited cancer growth and reduced cancer volume.Conclusion125I seed implantation kills pancreatic cancer cells, especially at 4 Gy. 125I-induced apoptosis and changes in DNMT1 and DNMT3b expression suggest potential mechanisms underlying effective brachytherapy.

Skills and the clinical application of CT guided radioactive seed 125I implantation in treating multiple lung metastatic masses

背景与目的125I粒子植入治疗肺转移瘤，常因胸部结构复杂，而被视为禁区。本研究旨在探讨CT引导125I粒子组织间植入治疗多发肺转移瘤的技术方法和疗效。方法在CT引导下对30例患者的115个肺转移灶，行肿瘤内125I粒子植入。据多发肺转移瘤的不同位置，肺门部、周围性、胸廓骨骼遮挡肺小结节病变采用相应穿刺植入方法，并行疗效评价。结果一次穿刺成功为84.3%（97/115），粒子分布均匀。术后一周复查补种成功为15.7%（18/115）。随访6-24个月，平均14.6个月，CT复查115个病灶中结节完全缓解（complete response, CR）80个，部分缓解（partial response, PR）20个，无变化（No change, NC）8个，疾病进展（progressive disease, PD）7个，总有效率为86.9%。1年局部控制率为93.9%（108/115）。围手术期无严重并发症。结论CT引导下采用不同穿刺方法植入放射性125I粒子治疗多发肺转移瘤安全微创，并发症发生率低，疗效肯定，是一种微创治疗方法。

CT guided 125I seeds implantation in treatment of local recurrent rectal cancer after surgery resection: analysis of 21 cases

To explore the clinical value of CT guided 125I seeds implantation in the treatment of local recurrent rectal cancer after surgery resection. Twenty-one patients with local recurrent rectal cancer after surgery, 12 males and 9 females, aged 47 (35-69), with the longest diameter of 4. 2 cm (3.4 - 6.4 cm), were treated by CT guided 125I radioactive seeds implantation according to treatment planning system (TPS) or Halarism's experienced function: mCi = Da x 5. Totally, 506 seeds, 24.1 for one patient on average, were implanted. All the patients received PET-CT scan 3 months after the treatment and were followed up for 12.5 months (7-22 months). Complete remission, partial remission, and no change were seen in 16, 3, and 2 patients respectively. All patients survived. CT guided 125I seeds implantation is an effective methods in the treatment of local recurrent rectal cancer after surgery resection.