title: Computed tomographic-guided iodine-125 interstitial implants for malignant thoracic tumors.
abstract: OBJECTIVE
  To evaluate the feasibility and efficacy of percutaneous interstitial brachytherapy using iodine-125 ((125)I) radioactive seeds under computed tomographic (CT) guidance for malignant thoracic tumors.
  
  
  METHODS
  Forty-one patients (34 males, 7 females; 18-90 years; mean, 63.7 years) with 77 lesions (3 in the mediastinum, 7 in the chest wall, 67 in the lung) underwent percutaneous interstitial implantation of (125)I radioactive seeds under CT guidance. A treatment planning system (TPS) was employed to calculate the number and distribution of seeds preoperatively. An 18-G needle was inserted into the lesions under CT guidance and send the seeds according to TPS. Two patients with mediastinal lesions undergoing seed implantation received an artificial pneumothorax. One patient with lung carcinoma adjacent to the anterior mediastinum underwent seed implantation through the sternum. Follow-up CT was done every 2 months postoperatively.
  
  
  RESULTS
  The procedure was successful in all patients. No major procedure-associated death occurred. The mean duration of follow-up was 19.4 ± 1.3 months (3-49 months). A complete response (CR) was seen in 49 lesions (63.6%), partial response (PR) in 9 lesions (11.7%), stable disease (SD) in 12 lesions (12.8%), and progressive disease (PD) in 7 lesions (7.4%). The overall response rate (CR+PR) was 75.3%; the local control rate (CR+PR+SD) was 90.9%. The 1-, 2- and 3-year progression-free rates for local tumors were 91%, 88% and 88%, respectively. The 1-, 2- and 3-year survival rates were 87%, 74% and 68%, respectively.
  
  
  CONCLUSIONS
  Implantation of CT-guided (125)I seeds is feasible and effective for patients with malignant thoracic tumors.
authors.affiliation: The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China; The Department of Radiology, Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan Bei Road, Quanzhou 362000, China.
authors.forename: Qiming
authors.initials: Q
authors.lastname: Huang
authors.forename: Jin
authors.initials: J
authors.lastname: Chen
authors.forename: Qunlin
authors.initials: Q
authors.lastname: Chen
authors.forename: Qingquan
authors.initials: Q
authors.lastname: Lai
authors.forename: Siqing
authors.initials: S
authors.lastname: Cai
authors.forename: Kaidong
authors.initials: K
authors.lastname: Luo
authors.forename: Zhengyu
authors.initials: Z
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals
keywords: (125)I seed; Brachytherapy; Computed tomography; Malignant thoracic tumor; Mediastinum; X-ray