CT-guided 125I Seeds Implantation Research Articles

PO113: Advantages of 3D Printing Template Precede CT Guided 125I Seed Implantation for Recurrent and Metastatic Cancer of Head and Neck

PO113: Advantages of 3D Printing Template Precede CT Guided 125I Seed Implantation for Recurrent and Metastatic Cancer of Head and Neck

CT-guided Radioactive 125I Seed Implantation for Abdominal Incision Metastases of Colorectal Cancer: Safety and Efficacy in 17 Patients

IntroductionTo retrospectively evaluate the safety and efficacy of computed tomography (CT)-guided iodine-125 (125I) seed implantation for patients with abdominal incision metastases from colorectal cancer. Materials and MethodsData of patients with abdominal incision metastases of colorectal cancer from November 2010 to October 2020 were retrospectively reviewed. Each incisional metastasis was percutaneously treated with 125I seed implantation under CT guidance. Follow-up contrast-enhanced CT was reviewed, and the outcomes were evaluated in terms of objective response rate, complications, and overall survival. ResultsA total of 17 patients were enrolled in this study. The median follow-up was 18 months (range, 2.7-22.1 months). At 3, 6, 12, and 18 months after the treatment, objective response rate was 52.9%, 63.6%, 33.3%, and 0%, respectively. A small amount of local hematoma occurred in two patients and resolved spontaneously without any treatment. Two patients experienced a minor displacement of radioactive seeds with no related symptoms. Severe complications, such as massive bleeding and radiation injury, were not observed. No ≥ grade 3 adverse events were identified. By the end of follow-up, 14 patients died of multiple hematogenous metastases. The one-year overall survival rate was 41.6%, and the median overall survival was 8.6 months. ConclusionCT-guided 125I seed implantation brachytherapy is safe and feasible for patients with abdominal incision metastases from colorectal cancer.

CT-guided trans-sternal iodine-125 seeds implantation for masses in the anterior or middle mediastinum.

PurposeThe aim of this study was to explore the feasibility and clinical value of computed tomography (CT)-guided trans-sternal puncture to implant 125I seeds to treat masses in the anterior or middle mediastinum.Material and methodsFrom September 2017 to December 2019, twenty patients with masses in the anterior or middle mediastinum were enrolled and treated with CT-guided trans-sternal 125I seeds implantation. Dosimetry parameters were compared between post-operative and pre-operative plans. Satisfaction rate of 125I seed distribution, complications, and local efficacy were evaluated.ResultsA total of 22 lesions were treated with 125I implantation in twenty patients, all procedures being successfully completed. The dosimetry parameters of the 20 patients immediately after surgery were as follows: mean D90 = 134.30 ±14.53 Gy; mean V90, V100, V150, and V200 were 96.10 ±1.55%, 92.69 ±1.93%, 66.86 ±7.53%, and 42.95 ±9.11%, respectively; mean conformity index (CI), external index (EI), and homogeneity index (HI) were 0.65 ±0.06, 40.79 ±13.72%, and 27.90 ±7.53%, respectively. The satisfaction rate of 125I seed distribution was 90%. The mean follow-up duration was 12 ±4.75 months (range, 4-24 months). The local control rates of 2 months, 6 months, and 1 year after surgery were 65.0%, 64.7%, and 53.8%, respectively. One patient had a small degree of pneumothorax, and one had hemoptysis after surgery.ConclusionsCT-guided trans-sternal puncture plant 125I seeds for the treatment of masses in the anterior or middle mediastinum might serve as an alternative approach for treating specific mediastinal metastatic tumors.

PO49: Quality Evaluation and Curative Effect Observation of Individualized 3D Printing Template Combined with CT Guided 125I Seed Implantation in the Treatment of Inoperable Limb Soft Tissue Sarcoma

Purpose: To evaluate the dosimetric parameters of 3D printing individualized template combined with CT guided 125I seed implantation, and to explore the efficacy and safety of radioactive 125I seed interstitial implantation in the treatment of unresectable soft tissue sarcoma.

Miscellaneous PO49: Quality Evaluation and Curative Effect Observation of Individualized 3D Printing Template Combined with CT Guided 125I Seed Implantation in the Treatment of Inoperable Limb Soft Tissue Sarcoma

Miscellaneous PO49: Quality Evaluation and Curative Effect Observation of Individualized 3D Printing Template Combined with CT Guided 125I Seed Implantation in the Treatment of Inoperable Limb Soft Tissue Sarcoma

PO56: CT-Guided 125I Seed Implantation by Coplanar Template as a Salvage Therapy for Cervical Lymph Node Recurrence of Thoracic Esophageal Squamous Cell Carcinoma after External Beam Radiotherapy

PO56: CT-Guided 125I Seed Implantation by Coplanar Template as a Salvage Therapy for Cervical Lymph Node Recurrence of Thoracic Esophageal Squamous Cell Carcinoma after External Beam Radiotherapy

PO56: CT-Guided 125I Seed Implantation by Coplanar Template as a Salvage Therapy for Cervical Lymph Node Recurrence of Thoracic Esophageal Squamous Cell Carcinoma after External Beam Radiotherapy

Purpose: To analysis outcome and prognosis of computed tomography (CT)-guided 125I seed implantation by coplanar template in patients with cervical lymph node recurrence after multimodal treatment of thoracic esophageal squamous cell carcinoma. The purpose of this study is also to compare the preoperative and postoperative dosimetry of 3D printing coplanar template assisted particle implantation, and to explore the accuracy of this technology in the treatment of radioactive particle implantation.

Locally advanced pancreatic carcinoma with jaundice: the benefit of a sequential treatment with stenting followed by CT-guided 125I seeds implantation

ObjectivesTo evaluate the role of sequential therapy with percutaneous biliary stenting and CT-guided iodine-125 seed implantation for locally advanced pancreatic carcinoma with concomitant obstructive jaundice.MethodsBetween January 2016 and December 2018, 42 patients diagnosed with locally advanced pancreatic carcinoma with concomitant obstructive jaundice were enrolled retrospectively. All patients received biliary stenting via percutaneous transhepatic biliary drainage (PTBD) to alleviate obstructive jaundice. Thereafter, twenty-two patients underwent CT-guided iodine-125 seed implantation (treatment group), and 20 did not (control group). The prescribed dose in the treatment group was 110–130 Gy. The clinical data, duration of biliary stent patency, and overall survival (OS) were evaluated.ResultsOverall, the total bilirubin level decreased from 275.89 ± 115.44 to 43.08 ± 43.35 μmol/L (p < 0.001) 1 month after percutaneous biliary stenting. In the treatment group, the postoperative median dose covering 90% of the target volume was 129.71 Gy. Compared with the control group, the treatment group had a long mean duration of biliary stent patency and median OS (11.42 vs. 8.57 months, p < 0.01; 11.67 vs. 9.40 months, p < 0.01, respectively). The overall positive response rates 6 months post-treatment in the treatment and control groups were 72.7% (16/22) and 30% (6/20), respectively. Adverse events of more than grade 3 were not observed during the follow-up.ConclusionSequential therapy with percutaneous biliary stenting and CT-guided iodine-125 seed implantation is an effective and safe treatment alternative for locally advanced pancreatic carcinoma with concomitant obstructive jaundice, which is worthy of clinical application.Key Points• Obstructive jaundice was alleviated after biliary stent placement in all patients, and the total bilirubin level decreased.• The overall positive response rates at 6 months post-treatment were higher in the treatment group than in the control group, and adverse events of more than grade 3 were not observed during the follow-up period.• Sequential therapy with percutaneous biliary stenting and CT-guided iodine-125 seed implantation can prolong biliary stent patency and improve survival.

Therapeutic Effect of CT-guided ¹²⁵I Seed Implantation on Advanced Lung Cancer and Pulmonary Metastatic Carcinoma

背景与目的原发性肺癌及肺转移癌均为常见肺部恶性肿瘤，是主要的癌症相关死亡原因。晚期肺癌及肺转移癌以全身治疗为主，局部治疗对全身治疗后肺部残存的顽固性病灶或复发病灶为一种有效治疗手段。125I放射性粒子植入作为一种高效的适形放疗，对肺部局限性癌灶具有一定的控制作用。本研究旨在探讨计算机断层扫描（computed tomography, CT）引导下经皮穿刺肺组织间125I放射性粒子植入治疗晚期肺癌和肺转移癌的临床效果及安全性。方法连续性收集2014年1月1日-2018年11月30日浙江大学医学院附属第一医院胸外科行125I放射性粒子植入术治疗的105例晚期肺癌和肺转移癌患者的临床病理资料，术后随访至2019年3月。观察粒子植入术的临床疗效及并发症发生情况。结果本研究共纳入105例患者，晚期肺癌患者78例，肺转移癌患者27例。粒子治疗患者术后中位生存时间为395天，术后1年生存率约为78.1%，术后2年生存率约为56.1%。粒子植入治疗晚期肺癌的效果与肺转移癌的效果相当。粒子联合射频消融、微波消融、化疗并没有提高粒子治疗效果。但是粒子联合外放射治疗较单纯粒子治疗具有显著生存劣势。结论CT引导下125I放射性粒子植入术并发症可控，可以作为晚期肺癌和肺转移癌的一种安全有效的治疗方法。

Factors influencing the short-term efficacy of CT-guided 125I seeds implantation in the treatment of recurrent and metastatic tumors of head and neck

Objective To analyze the factors influencing the short-term efficacy of CT-guided 125I seeds implantation in the treatment of recurrent and metastatic tumors in head and neck. Methods A total of 73 patients (61 males, 12 females; age: (59.1±11.5) years) with head and neck tumors recurrence and metastasis treated by 125I seeds implantation in Hebei General Hospital from January 2015 to April 2019 were retrospectively enrolled. The implanted seeds activity was 11.1-29.6 MBq, and the prescription dose was 80.0-145.0 Gy. CT examination was conducted 3 months after 125I seeds implantation. According to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, short-term efficacy was classified as effective (complete remission (CR), partial remission (PR)) and ineffective (stable disease (SD), progressive disease (PD)). Univariate analysis of factors affecting short-term effect (gender, age, history of radiation therapy, Karnofsky performance status (KPS) scores, pathological type, the longest diameter of tumor, implantation patterns, seeds activity, immediate postoperative dose delivered to 90% gross tumor volume (D90), and with adjuvant chemotherapy post-surgery or not) were conducted. Variables with P<0.2 were enrolled in logistic multivariate regression analysis. In addition, artificial neural network (ANN) was constructed with all influencing factors as independent variables and short-term efficacy as dependent variables. Finally, receiver operating characteristic (ROC) curve analysis was performed for the common influencing factors in logistic regression analysis and ANN analysis. Results There were 34 with effective results and 39 with ineffective results. Logistic regression analysis indicated that the longest diameter of tumor, immediate postoperative D90, with adjuvant chemotherapy post-surgery or not had significant impacts on the short-term efficacy (Wald values: 6.950, 4.804, 4.790, all P<0.05); According to results of ANN analysis, the top 5 in order of importance for short-term efficacy prediction were immediate postoperative D90, the longest diameter of tumor, age, seeds activity and gender. ROC curve analysis indicated that the longest diameter of tumor and immediate postoperative D90 were the best predictors for short-term efficacy, with the threshold of 5.25 cm and 110.05 Gy respectively, and the area under the curve (AUC) was 0.843 and 0.847 respectively (both P<0.001). Conclusions The short-term efficacy of 125I seeds implantation in the recurrence and metastasis of head and neck tumors is mainly related to the longest diameter of tumor and immediate postoperative D90. Patients with the longest diameter of tumor 110.05 Gy can achieve better efficacy. Key words: Head and neck neoplasms; Recurrence; Neoplasm metastasis; Brachytherapy; Iodine radioisotopes; Radiotherapy, image-guided; Tomography, X-ray computed

Radiation-related Adverse Effects of CT-guided Implantation of 125I Seeds for Thoracic Recurrent and/or Metastatic Malignancy

During radioactive Iodine-125 seed implantation (RISI), Iodine-125 radionuclide is implanted directly into a lesion and kills tumor cells by steadily emitting radiation. In our study, we analyzed the adverse effects of RISI for thoracic malignancy, and investigated the safety, dosage, and adverse effects of RISI for these cases. Between June 2007 and January 2018, 77 patients with thoracic recurrent and/or metastatic tumors who underwent CT-guided RISI were enrolled. Radiation-related adverse effects were analyzed, including pneumonia, esophagitis, hemorrhage, fistula, skin injury, heart injury, and spinal cord injury. We used the Common Terminology Criteria for Adverse Events (CTCAE) v4.03 to evaluate adverse effects and analyzed the relationship between adverse effects and dosimetric parameters of organs at risk (OAR), including D0.1cc, D2cc, Dmean, and V20. The results of the study were as follows: The median follow-up period was 11 months. The median postoperative dose (D90) was 122 Gy (45.7–241.8 Gy). Three patients (3.9%) showed radiation pneumonitis of grade ≥2. Two patients (2.6%) showed radiation-induced esophagitis of grade ≥2. One patient (1.3%) showed an esophageal fistula. Two patients (2.6%) had a tracheal fistula. Five patients (6.5%) had radiation-related skin reactions. One patient (1.3%) reported chest wall pain, while three (3.9%) showed hemoptysis. No patients showed radiation myelitis or cardiotoxicity. The mean D2cc of organs at risk were 165.7 Gy (lung), 10.61 Gy (esophagus), 10.25 Gy (trachea), 18.07 Gy (blood vessel), 12.64 Gy (heart), 14.77 Gy (spinal cord), 17.47 Gy (skin). Dosimetric parameters, such as D0.1cc, D2cc and Dmean, were higher in patients with toxic reactions (above the upper limit of 95% confidence interval among the overall data). Chi-square test showed that skin D0.1cc > 600 Gy, D2cc > 500 Gy, and Dmean >90 Gy were associated with grade ≥2 radiation dermatitis (p < 0.05), but no clear dose-toxicity correlation was found in other OARs. So, we concluded that the overall incidence of toxicity and adverse effects from RISI for the treatment of thoracic tumors is low. The dose-toxicity characteristics have not been fully defined. Doses within the upper limit of the 95% confidence interval may be considered safe. This was a retrospective analysis, and follow-up period was minimal, indicating possible limitations of this study.

Efficacy and Prognosis of CT-Guided Implantation of 125I Seeds As Salvage Treatment for Recurrent Nasopharyngeal Carcinoma after External Beam Radiotherapy--a Long-Term Experience at a Single Institution

To assess the safety and efficacy of computed tomography (CT)-guided 125I seeds implantation for recurrent nasopharyngeal carcinoma (NPC) after external beam radiotherapy (EBRT). Twenty-nine patients with recurrent NPC (thirty-nine lesions) after EBRT from February 2003 to December 2017 were enrolled. All the patients experienced preoperative assessment, patient immobilization, and CT scan, preoperative planning, 125I seeds implantation, postoperative dosimetry assessment, and postoperative care. Median radioactivity of 125I seeds was 0.61 (range, 0.22-0.79) mCi. Median number of implanted seeds was 34 (3-83). Median value of D90 was 136 (62.4-246) Gy. The adverse event was evaluated by the Radiation Therapy Oncology Group (RTOG) classification criteria. Overall survival (OS), local control (LC), local progression-free survival (LPFS), were investigated for their relationship with the prognosis. Median duration of follow-up was 13.7 (4.4-71.2) months. Median duration of LC was 31.6 (2.1-60.2) months. LC at 1, 3, and 5 years was 69.0%, 46.7% and 18.7%, respectively. Median duration of OS was 33.4 (4.4∼71.2) months. OS at 1-, 3- and 5-years was 73.8%, 40.8% and 40.8%, respectively. Median duration of LPFS was 22.6 (3.0-60.2) months. LPFS at1-, 3- and 5-years was 72.0%, 38.7% and 38.7%, respectively. Univariate analysis suggested that sex(P=0.048) and frequency of previous external beam radiotherapy (P=0.018) were prognostic factors influencing survival without local recurrence. Moreover, sex (P=0.023), frequency of previous EBRT (P=0.001), time from the first EBRT to seeds implantation (P=0.007), and D90 (P=0.049) were prognostic factors influencing LC. Multivariate retrospective analysis indicated that sex (P=0.03) was an independent prognostic factor for survival without local recurrence. Prevalence of side effects (≥grade 3) was 20.7%. 125I seeds implantation was a safe and feasible salvage treatment for recurrent NPC after EBRT.

Efficacy and Safety of CT-Guided 125I Seed Implantation As a Salvage Treatment for Locally Recurrent Head and Neck Soft Tissue Sarcoma after Surgery and External Beam Radiotherapy: A 12-Year Study at a Single Institution

The treatment for locally recurrent head and neck soft tissue sarcoma (HNSTS) after failure of previous surgery and external beam radiotherapy (EBRT) remains a problematic challenge without widely accepted recommendations. We aimed to evaluate the efficacy and safety of CT-guided radioactive 125I seed (RIS) implantation for the treatment of locally recurrent HNSTS after surgery and EBRT and analyze the prognostic factors of efficacy. Between December 2006 and February 2018, 25 patients with locally recurrent HNSTS after failure of surgery and EBRT were erolled. We re-staged the recurrent tumors according to the American Joint Committee On Cancer (AJCC) System for soft tissue sarcoma of the head and neck sarcoma (8th ed, 2017) when analyzing the data. All these patients successfully underwent treatment with computed tomography (CT)-guided 125I seed implantation. The postoperative evaluation of seed and dose distribution was performed immediately after surgery. The primary endpoints included the objective overall response rate (ORR) and local progression-free survival (LPFS), and the secondary endpoints were overall survival (OS) and safety profiles. Following 125I seed implantation brachytherapy, the ORR was 72.0%, median LPFS was 16.0 months and median OS was 28.0 months. Furthermore, the 1-, 2-, 3-, 4- and 5-year LPFS rates were 65.6%, 48.1%, 34.4%, 22.9%, and 22.9% respectively and the 1-, 2-, 3-, 4- and 5-year survival rates were 70.8%, 56.9%, 46.6%, 40.8%, and 34.0%, respectively. Multivariate analyses showed that the recurrent T stage (T4 vs ≤ T3；hazard ratio [HR]= 4.020; 95% confidence interval [CI]= 1.117-14.466; P=0.033) and histological grade (G3 vs ≤ G2；HR= 3.260; 95% CI= 1.031-10.306; P=0.044) were independent prognostic factors of LPFS, whereas only the histological grade (G3 vs ≤ G2；HR= 3.230; 95% CI=1.061-9.834; P=0.039) was an independent predictor of OS. The major adverse events were skin/mucosal toxicities, which were generally of lower grade (≤ grade 2) and well tolerated. RIS implantation could be an effective and safe alternative treatment for locally recurrent HNSTS after failure of surgery and EBRT. Recurrent T stage and histological grade were the main factors influencing the efficacy.

Effectiveness and Safety of CT-Guided 125I Seed Implantation for Patients with Advanced Non-Small-Cell Lung Cancer

To retrospectively investigate the clinical safety and efficacy of CT-guided 125I seed implantation in 36 locally advanced non-small cell lung cancer.

Efficacy analysis of CT-guided 125I seeds implantation combined with chemotherapy in the treatment of unresectable non-small cell lung cancer

Objective To investigate the clinical efficacy of CT-guided 125I seeds implantation combined with gemcitabine + cis-platinum (GP) in the treatment of unresectable non-small cell lung cancer (NSCLC). Methods From January 2013 to January 2017, 62 patients with unresectable Ⅱb-Ⅲb NSCLC were randomly divided into 2 groups. In the study group, 32 patients (17 males, 15 females, age (62.7±8.9) years) underwent 125I seeds implantation combined with 4 courses of GP chemotherapy, and 30 patients (18 males, 12 females, age (61.9±7.0) years) in the control group underwent concurrent radiotherapy combined with 4 courses of GP chemotherapy. The short-term effects at 3 and 6 months after treatment were compared between 2 groups, as well as the survival time. Log-rank test was used to analyze the data. Results The effective rates at 3 and 6 months after treatment in the study group and control group were statistically significant (90.62%(29/32) vs 70.00%(21/30), 96.88%(31/32) vs 66.67%(20/30); χ2 values: 3.00 and 7.22, both P 0.05). The 1-year survival rates of 2 groups were 87.50%(28/32) and 76.67%(23/30), respectively (χ2=1.24, P>0.05), and the 2-year survival rates were 40.62%(13/32) and 20.00%(6/30), respectively (χ2=4.00, P<0.05). Conclusions 125I seeds implantation combined with GP chemotherapy is a significant treatment for unresectable NSCLC. The short-term efficacy is better than concurrent radiotherapy combined with GP regimen. Key words: Carcinoma, non-small-cell lung; Brachytherapy; Iodine radionuclide; Tomography, X-ray computed; Drug therapy, combination

The Application of External Fixator in Ct Guided 125i Seeds Implantation to Treat Head and Neck Neoplasms

The Application of External Fixator in Ct Guided 125i Seeds Implantation to Treat Head and Neck Neoplasms

Efficacy of computed tomography-guided implantation of 125I seeds in the treatment of refractory malignant tumors accompanied with cancer pain and its influence on tumor markers in the serum.

This study intended to explore the efficacy of computed tomography (CT)-guided implantation of iodine-125 (125I) seeds in the treatment of refractory malignant tumors with cancer pain and its influence on tumor markers in the serum. 76 patients with refractory malignant tumors accompanied by cancer pain that received treatments in LongHua Hospital Shanghai University of Traditional Chinese Medicine from September 2013 to August 2014 were selected. They were divided into control group and observation group using a random number table (38 patients in each group). Patients in the control group received simple chemotherapy, while those in the observation group undergone CT-guided implantation of 125I seeds in combination with chemotherapy. Recent efficacy and 1-3-year survival rate were compared between the two groups of patients. The degree of pain relief after treatment was also compared between the two groups of patients. Electrochemiluminescence method was used to detect the concentrations of carcinoembryonic antigen (CEA), sugar chain antigen 199 (CA 199), sugar chain antigen 125 (CA 125), neuron-specific enolase (NSE) and cytokeratin-19-fragment (CYFRA21-1) in the two groups of patients before treatment, and 3 days, 7 days and 30 days after treatment. Recent disease control rate of the patients in the observation group was higher than that of the patients in the control group (p<0.05). The 1-3-year survival rate after surgery in the observation group was significantly higher than that in the control group (p<0.05). The total efficiency of pain control in the observation group was significantly higher than that in the control group (p<0.05). The levels of tumor markers in the two groups of patients were significantly decreased after treatment, while the reduction in the observation group was more evident than that in the control group (p<0.05). Our results showed that CT-guided implantation of 125I seeds is effective for the treatment of patients with refractory malignant tumors accompanied by cancer pain. It can reduce the levels of tumor markers, improve the survival rate and prolong the survival time of the patients.

Side effects of CT-guided implantation of 125I seeds for recurrent malignant tumors of the head and neck assisted by 3D printing non co-planar template

BackgroundFor the recurrence of head and neck cancer after operation and radiotherapy, the local control of radioactive seed implantation is good, and it has a certain palliative effect. This study aims to investigate the acute and late side effects of a three-dimentional printing non co-planar template (3D–PNCT) for computed tomography (CT)-guided radioactive 125I seed (RIS) implantation in recurrent cancer of the head and neck.MethodsBetween January 2016 and December 2016, forty-two patients with local recurrent malignant tumors of the head and neck received 3D–PNCT-assisted RIS implantation. The prescribed dose was 110–160 Gy. Preoperative planning design, production of individual guide plates, RIS implantation, postoperative dose evaluation, and follow-up were completed for all patients. Side effects in the skin, mucous membranes, blood and spinal cord were evaluated.ResultsAll patients underwent surgery successfully. Duration of follow-up was 4–14 (median, of 8.5) months. The activity of a single RIS was 0.34–0.7 (median, 0.6) mCi. The number of RIS was 10–126 (median, 34). The number of implantation needles was 4–31 (median, 11). The mean D2cc (dose to the most exposed 2-cc volume) and D0.1cc (dose to the most exposed 0.1-cc volume) of the skin were 24.9 (7.1–85.5) and 47.5 (9.4–167.2), respectively, whereas those of the spinal cord were 8.4 (4.5–33.3) and 14.2 (13.6–63.0), mucosa were 35.1 (4.2–82.8) and 87.0 (6.6–214.1), parotid glands were 16.2 (12.8–19.7) and 29.8 (26.1–33.4) and those of the trachea were 17.9 (2.5–45.9) and 32.7 (3.9–83.9), respectively. No case had an acute reaction of grade ≥ 3. Three cases had a grade-1 skin reaction. Blood toxicity did not occur, nor spinal-cord injury. Xerostomia was not aggravated than that of before brachytherapy. One case had a grade-3 nerve response.Conclusions3D–PNCT-assisted RIS implantation can provide good accuracy for positioning. For local recurrent malignant tumor of head and neck, there were no obvious adverse reactions.

Dosimetry evaluation for CT guided 125I seeds implantation assisted by three-dimensional-printing coplanar coordinate template in chest malignant tumor

Objective To verify the accuracy of three-dimensional printing coplanar coordinate template (3D-PCCT) technology for 125I seeds implantations in chest tumor at dosimetry level. Methods From January 2016 to June 2017, a total of 22 patients (15 males, 7 females; median age 62 years) with chest tumors who received 3D-PCCT assisted 125I seeds implantation in Peking University Third Hospital were enrolled in this retrospective study. There were 8 patients with primary lung cancer and 14 with metastatic carcinoma. The sites for implantation included lung (12 cases), mediastinum (2 cases) and chest wall (8 cases). The prescribed dose was 110-180 Gy. The preoperative plan design, puncture and seeds implantation guided by template were carried out and the dose distribution of postoperative plan was compared with that of preoperative plan. Dose parameters included dose delivered to 90% gross tumor volume (D90), minimum peripheral dose, the percentage of GTV receiving 100% prescription dose (V100), the percentage of GTV receiving 150% prescription dose (V150), conformity index, external index of target volume, uniformity index, D2 cm3 of spinal cord and aorta, and V20 of affected side lung. Wilcoxon signed rank test was used to analyze the data. Results The median D90 was 150.4(125.6, 187.0) Gy. Postoperative D90 was higher than the prescribed dose in 68%(15/22) cases. For median value of most parameters, there were no significant differences between the postoperative plans and preoperative plans (all P>0.05) except for the actual V100, which was lower than the preplanned (95.5% vs 97.2%; P=0.040). Conclusion 3D-PCCT could provide good accuracy in 125I seeds implantation for chest tumor. Key words: Thoracic neoplasms; Brachytherapy; Iodine radioisotopes; Printing, three-dimensional; Radiotherapy, image-guided; Tomography, X-ray computed; Radiation dosage

Clinical Efficacy of CT-Guided 125i Seed Implantation Therapy for the Patients with Vertebral Metastasis

Clinical Efficacy of CT-Guided 125i Seed Implantation Therapy for the Patients with Vertebral Metastasis