title: Computed tomography (CT)-guided interstitial permanent implantation of (125)I seeds for refractory chest wall metastasis or recurrence.
abstract: To evaluate the efficacy and safety of 125I seeds implantation for refractory chest wall (CW) metastasis or recurrence under CT guidance. In addition we assessed initial data obtained on the therapeutic response for refractory CW metastasis or recurrence. Twenty consecutive patients underwent permanent implantation of 125I seeds (from Jul. 2004 to Jan. 2011) under computed tomography (CT) guidance. Postoperative dosimetry was routinely performed for all patients. The actuarial D90 of the implanted 125I seeds ranged from 100 Gy to 160 Gy (median: 130 Gy). The activity of 125I seeds ranged from 0.5 mCi to 0.78 mCi (median: 0.71 mCi). The total number of seeds implanted ranged from 8 to 269 (median: 53). The follow-up period ranged from 3 to 54 months (median: 11.5 months). The survival and local control probabilities were calculated by the Kaplan-Meier method. Among all the 20 patients, 3 patients had complete remission CR (15%), 12 patients had partial remission PR (60%), 5 patients had stable disease SD. The 1-, 2-, 3- and 4-year tumor control rates were all 88.7% respectively. The 1- and 2-, 3-, 4-year cancer specific survival rates were 56.5% and 47.1%, 47.1%, 47.1% respectively. The 1- and 2-, 3-, 4-year overall survival rates were 53.3% and 35.6%, 35.6%, 35.6% respectively, with a median survival of 15 months (95% CI, 7.0-22.9). Mild brachial plexus injury was seen in one patient; grade 1 or 2 skin reactions were seen in 6 patients (30%) who had received external beam radiation therapy (EBRT) before. No grade 3 and 4 skin side effects were found. Rib fracture, ulceration, pneumothorax or hemopneumothorax were not seen. Interstitial permanent implantation of 125I seeds under CT guidance is feasible, efficacious and safe for refractory CW metastasis or recurrence.
authors: Department of Radiation Oncology, Peking University 3rd Hospital, Beijing 100191, P. R. China.
authors: Ping
authors: P
authors: Jiang
authors: Department of Radiology Oncology, Peking University 3rd Hospital, Beijing 100191, P. R. China.
authors: Chen
authors: C
authors: Liu
authors: Department of Radiation Oncology, Peking University 3rd Hospital, Beijing 100191, P. R. China junjiewang_edu@sina.cn.
authors: Junjie
authors: J
authors: Wang
authors: Department of Radiation Oncology, Peking University 3rd Hospital, Beijing 100191, P. R. China.
authors: Ruijie
authors: R
authors: Yang
authors: Department of Radiation Oncology, Peking University 3rd Hospital, Beijing 100191, P. R. China.
authors: Yuliang
authors: Y
authors: Jiang
authors: Department of Radiation Oncology, Peking University 3rd Hospital, Beijing 100191, P. R. China.
authors: Suqing
authors: S
authors: Tian
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging* / Q000532:radiotherapy* / Q000628:therapy; D009364:Neoplasm Recurrence, Local; D011879:Radiotherapy Dosage; D019233:Retreatment; D016019:Survival Analysis; D035441:Thoracic Wall / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes
keywords: 125I seed implantation.; Chest wall tumor metastasis recurrence radiotherapy