[Short-term efficacy of ct-guided radioactive seed 125I implantation on residual or relapsing metastatic lymph nodes in advanced tumor patients after multi-modality treatment].
OBJECTIVE
Lymph node metastasis is an important factor affecting tumor staging, treatment and prognosis. Residual or newly developed metastatic lymph nodes after combined therapy will bring difficulty in further treatment for cancer patients. This study was to investigate the clinical value of CT-guided radioactive seed 125I implantation in treating metastatic lymph nodes.


METHODS
From Nov. 2003 to Apr. 2007, 47 patients with pathologically confirmed malignant tumors received CT-guided radioactive seed 125I implantation to treat a total of 57 metastatic lymph nodes. The diameter of these metastatic lymph nodes ranged from 1.0 to 5.5 cm: 20 (35.1%) of them with diameter of < 2.0 cm, 21 (36.8%) with diameter of 2.0-2.9 cm, 10 (17.5%) with diameter of 3.0-3.9 cm, 6 (10.5%) with diameter of > or = 4.0 cm. Treatment planning system was used to design the distribution of seed 125I. Under CT guidance, 125I seeds of (2.2-3.3) x 10(7) Mq were implanted into the metastatic lymph nodes at a distance of 1.0-1.5 cm. CT or PET-CT re-examination was performed at 1-3 months after seed 125I implantation.


RESULTS
Seventeen patients had pain caused by metastatic lymph nodes and 13 of them had the pain relieved at 5-14 days after 125I implantation, with a response rate of 76.5%. Of the 47 patients, 38 (80.9%) achieved complete remission (CR), 4 (6.4%) achieved partial remission (PR), 3 (4.3%) had no change (NC), 2 (4.3%) had progressive disease (PD); the overall response rate was 89.4%. The major complication was slight hemorrhage developed in 7 patients (14.9%).


CONCLUSIONS
CT-guided radioactive seed 125I implantation is effective and safety in treating metastatic lymph nodes, with minimal damage and few complications.
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 5l0060, P. R. China.
Yong
Y
Jiang
Zi-Lin
ZL
Huang
Pei-Hong
PH
Wu
Fu-Jun
FJ
Zhang
Ming
M
Zhao
Jin-Hua
JH
Huang
Wei-Jun
WJ
Fan
Chuan-Xing
CX
Li
Yang-Kui
YK
Gu
Liang
L
Zhang
Fei
F
Gao
Wang
W
Li
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D003131:Combined Modality Therapy; D004067:Digestive System Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000473:pathology / Q000628:therapy; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008207:Lymphatic Metastasis / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000532:radiotherapy; D010147:Pain Measurement; D012074:Remission Induction; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D007457:Iodine Radioisotopes