title: Intraoperative gold grain implants for pelvic wall recurrences of various malignancies: toxicity, results, and failure analysis in 37 patients.
abstract: OBJECTIVE
  We conducted this study to determine the complications and long-term results of intraoperative gold-grain implants as therapy for pelvic wall recurrences of various malignancies.
  
  
  METHODS
  We retrospectively analyzed complications and long-term results of intraoperative radioactive 198Au gold grain implants of 4-mc radon equivalent in 37 patients with pelvic wall recurrences of various malignancies treated at the University of Texas M. D. Anderson Cancer Center. The estimated dose was 30-100 Gy, which was increased to 100-120 Gy plus external-beam irradiation if the dose to the tumor volume was too low. All patients had follow-up of 4 months to 12 years. Of the 37 patients, 34 had lower leg edema, 22 had lower limb pain, and 22 had ureteral obstruction.
  
  
  RESULTS
  Six of 34 patients with lower limb pain had partial relief and nine had complete relief. Of 22 patients with ureteral obstruction, ten had complete resolution and four had partial relief. Lower limb edema was improved in 16 of 22 patients. Of the 37 patients studied, 14 are alive and 23 have died.
  
  
  CONCLUSIONS
  In selected patients, gold grain implantation to a dose of 70-100 Gy relieved some symptoms of unresectable pelvic wall recurrences of various malignancies. We believe that intraoperative gold grain implants appear to be the only useful treatment for patients with recurrent malignancies fixed to the pelvic wall and provide these patients with better and longer palliation and a good quality of life.
authors.affiliation: University of Gaziantep, Sahinbey Medical Center, Department of Obstetrics and Gynecology, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Balat
authors.forename: C L
authors.initials: CL
authors.lastname: Edwards
authors.forename: L
authors.initials: L
authors.lastname: Delclos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000532:radiotherapy* / Q000601:surgery; D006050:Gold Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D007430:Intraoperative Care; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy* / Q000601:surgery; D010386:Pelvic Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006050:Gold Radioisotopes