Intraoperative ultrasound-guided iodine-125 seed implantation for unresectable pancreatic carcinoma.
BACKGROUND
To assess the feasibility and efficacy of using 125I seed implantation under intraoperative ultrasound guidance for unresectable pancreatic carcinoma.


METHODS
Fourteen patients with pancreatic carcinoma that underwent laparotomy and considered unresectable were included in this study. Nine patients were pathologically diagnosed with Stage II disease, five patients with Stage III disease. Fourteen patients were treated with 125I seed implantation guided by intraoperative ultrasound and received D90 of 125I seeds ranging from 60 to 140 Gy with a median of 120 Gy. Five patients received an additional 35-50 Gy from external beam radiotherapy after seed implantation and six patients received 2-6 cycles of chemotherapy.


RESULTS
87.5% (7/8) of patients received partial to complete pain relief. The response rate of tumor was 78.6%, One-, two-and three-year survival rates were 33.9% and 16.9%, 7.8%, with local control of disease achieved in 78.6% (11/14), and the median survival was 10 months (95% CI: 7.7-12.3).


CONCLUSIONS
There were no deaths related to 125I seed implant. In this preliminary investigation, 125I seed implant provided excellent palliation of pain relief, local control and prolong the survival of patients with stage II and III disease to some extent.
Wang
Junjie
J
Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, 100083, PR China. doctorwangjunjie@yahoo.com.cn
Jiang
Yuliang
Y
Li
Jinna
J
Tian
Suqing
S
Ran
Weiqiang
W
Xiu
Dianrong
D
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000601:surgery; D011859:Radiography; D011868:Radioisotopes / Q000627:therapeutic use; D014463:Ultrasonography
D007457:Iodine Radioisotopes; D011868:Radioisotopes