title: Refractory nasopharyngeal carcinoma: positron emission tomography combined with computed tomography-guided 125I seed implantation therapy after repeated traditional radiochemotherapy.
abstract: OBJECTIVE
  To evaluate the feasibility of positron emission tomography combined with computed tomography (PET-CT)-guided (125)I seed implantation in the treatment of patients with refractory nasopharyngeal carcinoma after repeated traditional radiochemotherapy.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  A total of 26 patients (18 men, 8 women; mean age, 51.3 ± 10.8 years; totaling 53 lesions with an average diameter of 2.86 ± 1.61 cm) were treated by PET-CT-guided (125)I seed implantation. All of the patients received a PET-CT scan 2 months after the treatment. Follow-up was conducted for ~2 to 43 months (median, 28.2 months) to observe the local control rate, overall survival rate, and clinical complications.
  
  
  RESULTS
  The local control rates of refractory nasopharyngeal carcinoma after repeated traditional radiochemotherapy after 3, 6, 12, 24, and 36 months were 90.6% (48/53), 79.3% (42/53), 71.7% (38/53), 62.3% (33/53), and 56.6% (30/53), respectively. The overall 1-, 2-, and 3-year survival rates were 87.2%, 71.3%, and 56.5%, respectively, with a median survival time of 28.2 months. Of all patients, 19.2% (5/26) died of local recurrence and 15.4% (4/26) died of metastases. One patient died of hypertensive cerebral hemorrhage, and another patient died from cachexia and infection. The long-term complications included hyperpigmentation at operative sites (n = 5), insensible feeling on the lateral cheek (n = 2), dryness of the oral cavity (n = 1), and headache (n = 1).
  
  
  CONCLUSIONS
  PET-CT-guided (125)I seed implantation is an acceptable and feasible method for treating refractory nasopharyngeal carcinoma with minimal damage and few complications.
authors.affiliation: Department of Medical Imaging & Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, P.R. China.
authors.forename: Fujun
authors.initials: F
authors.lastname: Zhang
authors.forename: Ketong
authors.initials: K
authors.lastname: Wu
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.forename: Weidong
authors.initials: W
authors.lastname: Zhang
authors.forename: Feng
authors.initials: F
authors.lastname: Shi
authors.forename: Chuanxing
authors.initials: C
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma; D059248:Chemoradiotherapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000532:radiotherapy*; D011877:Radionuclide Imaging; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes
keywords:    125I seed; PET-CT; nasopharyngeal carcinoma; radiochemotherapy; therapy