Seed Implantation Therapy Research Articles

Intraoperative implantation of 125I seeds improves prognosis in refractory stage IIIB cervical cancer: a case report and literature review

BackgroundConcurrent chemoradiation is the standard treatment for advanced cervical cancer. However some patients still have a poor prognosis, and currently, there is no effective treatment for recurrence. In recent years, 125I seed implantation therapy has emerged as a treatment for advanced malignant tumors including surgically unresectable tumors, residual tumors after surgical resection, and metastatic tumors. However, the use of 125I seeds implantation in primary advanced cervical cancer has not been reported. In this study, we present a case of stage IIIB cervical cancer in a patient who had poor response to radiotherapy and chemotherapy. Subsequently, a radical hysterectomy was performed, and 125I radioactive seeds were successfully implanted during the surgery. This effectively controlled the lesions that were resistant to radiotherapy and had the potential to improve the prognosis.Case presentationA 56-year-old woman was diagnosed with stage IIIB (FIGO 2009) IIIC1r (FIGO 2018) squamous carcinoma of the cervix. After receiving 4 cycles of platinum-based chemotherapy and 30 rounds of radiotherapy, she underwent a radical hysterectomy. The localized cervical lesions were reduced, but there was no reduction in the size of the enlarged pelvic lymph nodes. Therefore, 125I seed implantation was performed under direct surgical vision for the right paracervical lesion and the enlarged pelvic lymph nodes on the right side. During the 18-month follow-up period, the enlarged lymph nodes subsided without any signs of recurrence or metastasis.ConclusionIntraoperative implantation of 125I seeds in lesions that are difficult to control with radiotherapy or in sites at high risk of recurrence is a feasible and effective treatment option for patients with advanced squamous cervical cancer, and it may contribute to improved survival.

Chinese expert consensus on iodine-125 seed implantation for locally advanced differentiated thyroid cancer(2023 edition)

Iodine-125 seed implantation therapy provides an alternative method for persistent or recurrent thyroid cancer that cannot be operated again, cannot be controlled by iodine-131 therapy and is not suitable for targeted therapy, which is characterized by precise efficacy, safe and minimally invasive. However, due to the complex anatomical structure of the neck and the variable location of the target, the puncture path is limited, and sometimes it is difficult to meet the requirements of dosimetry or achieve homogenization, which seriously affects the efficacy and poses a great challenge to the promotion of this technique. In order to improve the level of comprehensive treatment for thyroid cancer, and better regulate the operation technology of radioactive iodine-125 seed implantation for thyroid cancer, led by the Committee of Minimally Invasive Therapy in Oncology, Chinese Anti-Cancer Association and Committee of Experts on radioactive particle implantation, Chinese Medical Doctor Association, the "Chinese expert consensus on Iodine-125 Seed Implantation for locally advanced differentiated thyroid cancer(2022 Edition)" was formulated, and the indications, contraindications, implantation methods, puncture paths, preoperative preparation, surgical procedures, surgical difficulties, adverse reactions, follow-up and other content of iodine-125 seed implantation for the treatment of differentiated thyroid cancer were introduced in detail, so as to provide reference for clinical practice.

Prognosis of adenoid cystic carcinoma in head and neck region treated with different regimens-A single-centre study.

No study has evaluated the impact of regimen on recurrence, metastasis and survival in patients with adenoid cystic carcinoma (ACC). The present study aimed to compare the efficacy of radioactive seed implantation and other regimens in treating ACC, so as to investigate the clinical applicability of radioactive seed implantation and determine the indications for this regimen. A total of 188 patients with ACC in oromaxillofacial region were allocated to four groups according to the treatment regimen: group 1 was treated with a combination of surgery and 125 I seed therapy, group 2 with a combination of surgery and external radiotherapy, group 3 with surgery, whereas group 4 was untreated. The Kaplan-Meier method was used to assess the survival rates, and the Cox regression analyses were used to identify the associated prognostic factors. The overall survival rates of 188 patients and groups 1, 2, 3 and 4 were 85.7%, 75%, 68.2% and 37.5%, respectively. Cox regression analysis revealed that age, T stage, N stage and regimen were independent prognostic factors of survival. Amongst patients with primary ACC, the efficacy of radioactive seed implantation was higher in those with perineural invasion than in those without. Patient age, T stage, N stage and regimen are independent prognostic factors of survival in patients with ACC. Patients treated with surgery combined with postoperative 125 I seed radiotherapy have a higher overall survival rate, and those with perineural invasion are more suitable for radioactive seed implantation therapy.

Computed tomography-guided iodine-125 radioactive seed implantation in small-cell lung cancer: A retrospective study.

To explore the efficacy of computed tomography (CT)-guided iodine-125 (125I) radioactive seed implantation for the treatment of small-cell lung cancer (SCLC). A total of 12 SCLC patients were retrospectively enrolled. All patients underwent CT-guided 125I seed implantation therapy, and were followed up until death, the last visit time, or study end time. Primary endpoint was the overall response rate (ORR). Secondary endpoints were local control rate (LCR), progression-free survival (PFS), overall survival (OS), and safety. All patients were successfully implanted with 125I radioactive seeds. The ORR at 2, 6, 12, and 24 months after implantation was 83.3%, 63.6%, 50%, and 40%, respectively; the LCR at 1 and 2 years were 75% (6/8) and 60% (3/5), respectively; the median PFS and OS were 8 and 12 months, respectively; and the OS rate at 6, 12, and 24 months after implantation was 91.67%, 66.67%, and 41.67%, respectively. No surgery-related deaths occurred. During the follow-up period, mild complications were observed in patients, including worsening cough, hemoptysis, and pneumothorax. CT-guided 125I seed implantation therapy is a safe and effective supplementary treatment for SCLC patients, who cannot tolerate radiotherapy.

Relationship between miR-7-5p expression and 125I seed implantation efficacy in pancreatic cancer and functional analysis of target genes*

Abstract Objective The aim of this study was to investigate the relationship between miR-7-5p expression and intertissue-125I irradiation sensitivity in pancreatic cancer tissues and to analyze the function of target genes. Methods Thirty-seven patients with unresectable pancreatic ductal adenocarcinoma (PDAC) treated with radioactive 125I seed implantation were enrolled. RT-PCR was used to detect the expression level of miR-7-5p in cancer tissues and analyze the relationship between miR-7-5p expression and 125I radiation sensitivity. Bioinformatic software and online tools were used to predict the miR-7-5p target genes and analyze their functional annotation and pathway enrichment. Results Radioactive 125I seed implantation was followed up for 2 months. The objective response rate of the miR-7-5p high expression group was 65.0% (13/20), whereas the objective response rate of the miR-7-5p low expression group was 5.88% (1/17), and the difference between the two groups was statistically significant (χ 2 = 13.654, P < 0.001). A total of 187 target genes were predicted using three databases. GO functional annotation showed that target genes were mainly involved in cellular response to insulin stimulus, regulation of gene expression by genetic imprinting, cytosol, peptidyl-serine phosphorylation, bHLH transcription factor binding, cargo loading into vesicles, cellular response to epinephrine stimulus, and nucleoplasm. KEGG pathway enrichment analysis showed that target genes were mainly involved in the ErbB signaling pathway, HIF-1 signaling pathway, axon guidance, longevity regulatory pathway, endocrine resistance, glioma, choline metabolism in cancer, and EGFR tyrosine kinase inhibitor drug resistance. Molecular complex detection analysis by Cytoscape revealed that PIGH, RAF1, EGFR, NXT2, PIK3CD, PIK3R3, ERBB4, TRMT13, and C5orf22 were the key modules of miR-7-5p target gene clustering. Conclusion The expression of miR-7-5p in pancreatic cancer tissues positively correlated with the radiosensitivity of 125I seeds. Via targeted gene regulation, miR-7-5p acts on the network of multiple signaling pathways in PDAC and participates in its occurrence and development. Thus, miR-7-5p may become a predictive index of 125I seed implantation therapy sensitivity in PDAC patients.

Advantages of interstitial radioactive seed implantation for the treatment of Stage III pancreatic cancer.

The objective of the study was to identify the advantages of interstitial radioactive seed implantation for the treatment of Stage III pancreatic cancer. Clinical data of 160 patients with pancreatic cancer implanted with radioactive seeds were retrospectively analyzed. Patients were grouped according to tumor size, lymph node metastasis, and tumor invasion to important blood vessels, and survival time statistics were obtained. The mean postoperative survival time (months) was 24.80 for Stage I, 12.89 for Stage II, 13.51 for Stage III, and 7.49 for Stage IV patients, and the difference between Stage II and Stage III patients was not statistically significant. The efficacy of radioactive seed implantation therapy for pancreatic cancer was strongly associated with tumor size and number of lymph node metastases but not significantly associated with tumor invasion to blood vessels. Radioactive seed implantation obviously advantageous for the treatment of Stage III pancreatic cancer.

To explore the curative effect of CT-guided Iodine-125 radioactive seed implantation in the treatment of stage Ⅳprimary hepatocellular carcinoma

ObjectivesTo explore the clinical efficacy and survival of CT-guided Iodine-125 radioactive seed implantation in the treatment of stage Ⅳ primary hepatocellular carcinoma. MethodsA retrospective study of 62 patients with primary hepatocellular carcinoma in our hospital from January 2017 to December 2018 [60 males, 2 females, age (52.76 ​± ​10.82) years old], All patients were implanted with Iodine-125 radioactive seeds under CT guidance, followed up regularly after operation to observe the clinical efficacy, including comparison of changes in cancer size before and after treatment, tumor marker AFP, and improvement in complications such as abdominal pain and ascites. Follow-up 3–36 months to assess patient survival. ResultsAmong the 62 patients, 3 months after Iodine-125 radioactive seed implantation, 5 cases (8.1%) had complete remission of cancer, 33 cases (53.2%) had partial remission, 12 cases (19.4%) had stable lesions, and 12 cases (19.4%) had disease progression. The effective rate was 61.3%. The tumor volume (31.44 ​± ​14.51cm3) was significantly smaller than before (50.96 ​± ​30.13cm3) (t ​= ​5.303, p ​< ​0.05). The tumor marker AFP (69.28 ​± ​50.99) ug/L of 3 months after implantation was significantly lower than that before treatment (90.63 ​± ​68.58) ug/L (t ​= ​3.702, P ​< ​0.05). The average survival time of Iodine-125 seed implantation for stageⅣhepatocellular carcinoma is 11.47 ​± ​0.85 months, and the median survival time is 9 months. The survival time of the group with better pathological differentiation (gradeⅠ+Ⅱ) was significantly better than that of the group with poor differentiation (grade Ⅲ+Ⅳ) (x2 ​= ​6.869 p ​< ​0.05). Among the 38 patients with different degrees of abdominal pain, 22 patients improved better than before; 15 of 28 patients with different degrees of ascites were better than before. All patients had no serious complications related to treatment. ConclusionsIodine-125 radioactive seed implantation therapy can safely and effectively treat hepatocellular carcinoma, and relieve the clinical symptoms of abdominal pain and ascites.

Therapeutic efficacy of TACE 125I seed implantation and its combination with intra-tumor injection of cisplatin for the treatment of hepatocellular carcinoma

This study aimed to compare the therapeutic efficacy of transcatheter arterial chemoembolization (TACE) combined with either 125I seed implantation or 125I seed implantation and intra-tumor injection of cisplatin in treating hepatocellular carcinoma (HCC).A total of 100 patients with HCC were analyzed. The control group (n = 50) received TACE combined with 125I seed implantation therapy. The therapy group (n = 50) was treated with an intra-tumor injection of cisplatin along with TACE and 125I seed implantation therapy. After treatment, routine blood, liver and kidney function, tumor volume, T lymphocyte subset count (CD3, CD4, and CD8), implanted metastases, and survival were studied.The tumor volume decreased by 27.4% on average in the control group, and by 38.6% in the therapy group. Alpha fetoprotein (AFP) level decreased in all cases, and it was significantly lower in the therapy group than in the control group. Remote metastasis was observed in both groups (7 in the control group and 3 in the therapy group). No significant difference in routine blood, liver and kidney function, and T-lymphocyte subset counts were found between the two groups. Eight patients died of metastases in the control group and 2 in the therapy group at 1-year follow-up (P < 0.05).TACE combined with either 125I seed implantation or 125I seed implantation and intra-tumor injection of cisplatin was effective for the treatment of HCC. Of the 2 combination therapies, TACE combined with 125I seed implantation and intra-tumor injection of cisplatin was more effective for the treatment of HCC.

A novel combination of percutaneous stenting with iodine-125 seed implantation and chemotherapy for the treatment of pancreatic head cancer with obstructive jaundice

PurposeInsertion of radioactive strips through the biliary stent has been reported to offer longer survival and patency than an uncovered conventional self-expanding metal stent in patients with unresectable malignant biliary obstruction. The aim of this study was to investigate the safety and effectiveness of intraluminal brachytherapy combined with 125I seed implantation and transarterial infusion chemotherapy for the treatment of pancreatic head cancer with obstructive jaundice. MethodFrom October 2012 to January 2018, 21 consecutive patients diagnosed with biliary obstruction caused by locally advanced, nonmetastatic pancreatic cancer with cytologically or histologically confirmed by biopsy were enrolled and receive treatment with intraluminal brachytherapy using 125I seed strand and CT-guided percutaneous radioactive seed implantation therapy. The procedure-related and radiation complications were assessed. The outcomes were measured in terms of stent patency, patient survival, complications related to the procedure. ResultOne of the 22 patients (4.5%, 1/22) with pancreatic head cancer failed to perform the above procedure because the guidewire was unable to pass through the obstruction segment. The remaining 21 patients (95.5%, 21/22) with pancreatic head cancer with obstructive jaundice were successfully placed with biliary stents and radioactive strips through drainage tubes. The median number of 125I seeds loaded was 15, ranging from 12 to 17. After the chemotherapy with gemcitabine and cisplatin, no adverse reaction of Grade Ⅲ ∼ Ⅳ occurred in all cases. Median stent patency was 12.50 months (95% CI: 10.26, 14.74). By May 2019, all 21 patients had died, with overall survival of 5.2–23.3 months, with a median survival of 13.20 months (95% CI: 10.96, 15.44). ConclusionPercutaneous 125I seed implantation combined with insertion of radioactive strips through the biliary stent has the characteristics of less trauma, fewer complications, simple operation, and so on. These procedures bring remission of obstructive jaundice combined with the increased survival for the treatment of obstructive jaundice caused by unresectable pancreatic head cancer if follow-up chemotherapy is carried out. The long-term efficacy of this treatment combination needs to be confirmed by further multicenter, large sample size prospective randomized controlled studies.

Significance of 125I radioactive seed implantation on growth differentiation factor and programmed death receptor-1 during treatment of oral cancer.

Oral cancer (OC) is the most common malignant tumor in the oral cavity, and is mainly seen in middle-aged and elderly men. At present, OC is mainly treated clinically by surgery or combined with radiotherapy and chemotherapy; but recently, more and more studies have shown that the stress trauma caused by surgery and the side effects of radiotherapy and chemotherapy seriously affect the prognosis of patients. To determine the significance of 125I radioactive seed implantation on growth differentiation factor 11 (GDF11) and programmed death receptor-1 (PD-1) during treatment of OC. A total of 184 OC patients admitted to The Second Affiliated Hospital of Jiamusi University from May 2015 to May 2017 were selected as the research subjects for prospective analysis. Of these patients, 89 who received 125I radioactive seed implantation therapy were regarded as the research group (RG) and 95 patients who received surgical treatment were regarded as the control group (CG). The clinical efficacy, incidence of adverse reactions and changes in GDF11 and PD-1 before treatment (T0), 2 wk after treatment (T1), 4 wk after treatment (T2) and 6 wk after treatment (T3) were compared between the two groups. The efficacy and recurrence rate in the RG were better than those in the CG (P < 0.05), while the incidence of adverse reactions and survival rate were not different. There was no difference in GDF11 and PD-1 between the two groups at T0 and T1, but these factors were lower in the RG than in the CG at T2 and T3 (P < 0.05). Using receiver operating characteristic (ROC) curve analysis, GDF11 and PD-1 had good predictive value for efficacy and recurrence (P < 0.001). 125I radioactive seed implantation has clinical efficacy and can reduce the recurrence rate in patients with OC. This therapy has marked potential in clinical application. The detection of GDF11 and PD-1 in patients during treatment showed good predictive value for treatment efficacy and recurrence in OC patients, and may be potential targets for future OC treatment.

Comparison of therapeutic effects of TACE combined with microwave ablation, 125I radioactive seed implantation, Apatinib targeted therapy for large hepatocellular carcinoma

Objective To observe the efficacy of transcatheter arterial chemoembolization (TACE) combined with microwave ablation, 125I radioactive seed implantation and Apatinib targeted therapy for large hepatocellular carcinoma. Methods 120 patients with large hepatocellular carcinoma admitted to our hospital from May 2015 to May 2017 were selected as the subjects and randomly divided into four groups. 30 patients in the control group were treated with TACE, 30 patients in the combined treatment group 1 were treated with TACE combined with microwave ablation, 30 patients in the combined treatment group 2 were treated with TACE combined with 125I radioactive seeds implantation, and 3 patients in the combined treatment group 3 were treated with TACE combined with Apatinib. The clinical efficacy, changes of alpha-fetoprotein (AFP), survival rate, levels of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) and adverse reactions were compared among the four groups. Results The disease control rate of the combined treatment group was significantly higher than that of the control group (P 0.05), while the survival rate of the combined treatment group 1 was significantly higher than that of the control group (P<0.05). After treatment, the levels of VEGF and MMP-9 in the four groups were significantly lower than those before treatment (P<0.05), and the combined treatment group was significantly lower than the control group (P<0.05). The incidence rates of adverse reactions such as elevated blood pressure, nausea and vomiting, skin itching, proteinuria and bone marrow suppression in the combined treatment group 1 were significantly lower than those in the control group (P<0.05), and the incidences of skin itching in the combined treatment group 2 and the combined treatment group 3 were significantly lower than those in the control group (P<0.05). Conclusions TACE combined with microwave ablation, 125I radioactive seed implantation and Apatinib targeting therapy for large hepatocellular carcinoma are more effective than TACE alone, and TACE combined with microwave ablation can significantly prolong the survival time of patients. Key words: Liver neoplasms; Catheterization; Chemoembolization, therapeutic; Hepatic artery; Microwaves; Ablation techniques; Iodine radioisotopes; Apatinib

Clinical efficacy of computed tomography-guided iodine-125 seed implantation therapy for patients with metastatic epidural spinal cord compression: A retrospective study.

This study evaluated the clinical efficacy of computed tomography (CT)-guided radioactive iodine-125 (125 I) seed implantation in patients with metastatic epidural spinal cord compression (MESCC). A cohort of 22 patients with MESCC were retrospectively enrolled. All patients underwent CT-guided 125 I seed implantation therapy via standard procedures. Clinical indexes, including the University of Texas MD Anderson Cancer Center (MDA) criteria for tumor responses, numerical rating scale (NRS) for the degree of pain, Karnofsky Performance Status (KPS) for quality of life, American Spinal Injury Association (ASIA) impairment scale, grade of ESCC, and radiation dose, were evaluated and recorded pre- and post-operation. A follow-up evaluation was performed at least 3 months after the operation. Finally, pre- and post-operative differences in these clinical indexes were compared. Overall survival was recorded. Operations were successfully performed on all patients. A median of 48 (range, 7-103) seeds were implanted in lesions, and the postoperative target verified dose D90 was 11,072.4 ± 1773.5 cGy. Patients were followed for a median of 6 months (range, 3-38 months). The median survival time was 10 months; the response rate was 18/22 (82%); the local control rates at 3, 6, and 12 months were 91.3%, 81.9%, and 81.9%, respectively; and the survival rates were 80%, 50.0%, and 21.9% at 6, 12, and 18 months, respectively. The ESCC grade was significantly lower (P < 0.05). Based on the ASIA impairment scale, the nerve functional reservation, recovery, and decline rates were 63.7% (14/22), 27.3% (6/22), and 9% (2/22), respectively. The NRS and KPS were both significantly improved in the 3rd month of follow-up (P < 0.05). CT-guided 125 I seed implantation represents an effective and safe palliative care for patients with MESCC, which can effectively relieve pain and spinal cord compression and improve nerve function and quality of life.

Expert consensus on computed tomography-assisted three-dimensional-printed coplanar template guidance for interstitial permanent radioactive 125I seed implantation therapy.

Interstitial permanent radioactive seed implantation delivers a high local dose to tumors and sharply drops off at surrounding normal tissues. Radioactive seeds implanted via ultrasound or computed tomography (CT) guidance are minimally invasive and facilitate quick recovery. Transrectal ultrasound-guided 125I seed implantation assisted by a transperineal plane template is standard for early-stage prostate carcinoma, with a highly consistent target volume dose distribution. The postplan dose evaluation is consistent with the preplan evaluation. Until now, there was no workflow for seed implantation elsewhere in the body, and it was difficult to effectively preplan for seed implantation because of patients' position changes, organ movement, and bone structure interference. Along with three-dimensional (3D) printing techniques and seed implantation planning systems for brachytherapy, coplanar and X Y axis coordinate templates were created, referred to as 3D-printed coplanar templates (3D-PCT). 125I seed implantation under CT guidance with 3D-PCT assistance has been very successful in some carcinomas. Preplanning was very consistent with postplanning of the gross tumor volume. All needles are kept parallel for 3D-PCT, with no coplanar needle rearrangement. No standard workflow for 3D-PCT-assisted seed implantation exists at present. The consensus topics for CT-assisted guidance compared to 3D-PCT-assisted guidance for seed implantation are as follows: Indications for seed implantation, preplanning, definition of radiation doses and dosimetry evaluation, 3D-PCT workflow, radiation protection, and quality of staff. Despite current data supporting 125I seed implantation for some solid carcinomas, there is a need for prospectively-randomized multicenter clinical trials to gather strong evidence for using 125I seed implantation in other solid carcinomas.

Preliminary clinical efficacy of iodine-125 seed implantation for the treatment of advanced malignant lung tumors.

This study aims to observe the preliminary clinical efficacy of percutaneous interstitial brachytherapy using iodine-125 seeds for the treatment of advanced malignant lung tumors. This retrospective study enrolled 24 patients in our hospital with advanced malignant lung tumors between June 2013 and November 2017. Computed tomography (CT)-guided iodine-125 seed implantation therapy was administered to these patients. All patients were followed up at 3, 6, and 12 months after the operation. The clinical efficacy was evaluated by CT. Among the 24 patients, the objective response rates at 3, 6, and 12 months after the procedure were 50.0%, 50.0%, and 33.3%, respectively. Recent occurrence of adverse reactions were observed, including four cases of pneumothorax, three cases of hemoptysis, and two cases of particle displacement. CT-guided percutaneous interstitial brachytherapy with iodine-125 seeds can be used for the treatment of lung malignant tumors. Its clinical curative effect is remarkable and it results in limited trauma, reducing the incidence of adverse reactions and improving patient quality of life.

3D-Printed Coplanar Template-Assisted Iodine-125 Seed Implantation Therapy in Patients with Pancreatic Cancer: A Pilot Study

Rationale: To evaluate a 3D-printed coplanar template for iodine-125 seed implantation therapy in patients with pancreatic cancer. Methods: A retrospective analysis of our database was performed, and a total of 25 patients with pancreatic cancer who underwent iodine-125 seed implantation between January 2014 and November 2017 were analyzed. Of these, 12 implantations were assisted by a 3D-printed coplanar template (group A), and 13 implantations performed freehand were selected as the control group (group B). A 3D coplanar template was designed and printed according to a preoperative CT scan and treatment planning system. The iodine-125 seeds were then implanted using the template as a guide. Dosimetric verification was performed after implantation. Pre- and postoperative D90, V100, and V150 were calculated. The success rate of iodine-125 seed implantation, dosimetric parameters and complications were analyzed and compared between the two groups. Results: Iodine-125 seed implantation was successfully performed in both groups. In group A, the difference in pre- and post-operative D90 was minimal and not statistically significant (P>0.05). Postoperative V100 and V150 were 91.05±4.06% and 64.54±13.40%, respectively, which met the treatment requirement. A better dosimetric parameter was observed in group A than in group B, and the difference was statistically significant. Conclusion: A 3D-printed coplanar template appears to be a safe and effective iodine-125 seed implantation guidance tool to improve implantation accuracy and optimize dosimetric distribution. Funding: This research was supported by the Natural Science Foundation of China. Competing Interest Declaration: The content of this manuscript haven’t been influenced by any conflict of interest. Ethics Approval Statement: The study was approved by the institutional review board, and all subjects signed an informed consent form.

Short-term efficacy of iodine-125 radioactive seed implantation therapy for hypoxic tumors

Objective To study the short-term efficacy of computed tomography (CT)-guided iodine-125(125I) radioactive seed implantation in the treatment of hypoxic tumors. Methods Twenty-two patients treated with 125I radioactive seed implantation in our department from 2014 to 2016 were divided into hypovascular tumor group (hypoxic group, n=12) and hypervascular tumor group (non-hypoxic group, n=10) based on the hemodynamics of solid tumor evaluated by color Doppler ultrasound. The enhanced CT images were loaded to the three-dimensional particle implantation planning system for preoperative planning. After 125I radioactive seed implantation, the D90 for target volume was verified to be 106-128 cGy. Treatment outcomes were evaluated according to the World Health Organization criteria at 1-3 months after surgery. Results In all the patients, the overall response rate was 82% at 3 months after surgery. There were no significant differences in response (complete response+ partial response) rates at 1, 2, or 3 months after surgery between the hypoxic group and the non-hypoxic group (P=0.840, 0.696, 0.840). Conclusions In the treatment of solid malignant tumor, 125I radioactive seed implantation can overcome the resistance of hypoxic tumor to radiotherapy in vitro and achieve satisfactory short-term efficacy. Key words: Iodine-125 radioactive seed; Hypoxic tumor; Short-term efficacy

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

Clinical Efficacy of CT-Guided Iodine-125 Seed Implantation Therapy in Unresectable Superficial Skin Cancer

Clinical Efficacy of CT-Guided Iodine-125 Seed Implantation Therapy in Unresectable Superficial Skin Cancer

Efficacy observation of (125)I seed implantation therapy for locoregional recurrent and metastatic breast cancer

To assess the efficacy and side effects of (125)I seed implantation for locoregional recurrent and metastatic breast cancer, and to discuss its role in the comprehensive therapy of breast cancer. Forty-three patients with locoregional recurrent or metastatic breast cancer were included in this study. They received (125)I seed implantation and were followed up to evaluate the efficacy and adverse reactions of the treatment. Among 54 lesions in the 43 cases, there were complete response (CR) in 39, partial response (PR) in 13, stable disease (SD) in 2 patients, with a response rate of 96.3%. All 17 cases with local pain achieved pain relief. With a median follow up of 36 months (range 14 to 60 months), the 1-, 3-, and 5-year local control rate was 85.2%, 53.7% and 1.9%, and the 1-, 3-, and 5-year survival rate was 95.3%, 67.4% and 37.2%, respectively. No serious radiotherapy side effect was observed. In patients with unresectable locoregional recurrent or metastatic breast cancer, (125)I seed implantation shows proved efficacy and few complications, and can be an important treatment option.

A Successful Case of Renal Transplantation from Deceased Donor Performed 7 Years after Radioactive Seed Implantation Therapy for Localized Prostate Cancer

There has been a significant increase in the number of patients with Prostate Adenocarcinoma (PCa) over the last decade, leading to a substantial rise of pre-transplant patients with a history of cured PCa. Currently, Radical Prostatectomy (RP) and brachytherapy using isotope seeds are good alternatives for treatment of localized low risk PCa. In this case, we performed a cadaveric renal transplantation for a patient who 7 years previously underwent radioactive seed implantation therapy for low risk PCa, as defined by the D’Amico classification system. The patient was a 66-year-old man with a history of hemodialysis for 24 years. Although radiation therapy can cause unfavorable inflammatory changes such as adhesions, we did not encounter any intraoperative difficulty, and the postoperative course has been uneventful and serum prostate specific antigen has remained undetectable even about 2 years after the transplant. In conclusion, We suggests that the brachytherapy for localized low-risk PCa seems to be a valid option for patients awaiting renal transplantation, and its lower invasiveness can be of great advantage to such PCa patients because the pre-transplant population often has a higher risk of perioperative complications due to longterm dialysis. However, careful perioperative anesthesia management is essential to perform the procedure for such potentially high risk patients.