Efficacy of permanent iodine-125 seed implants and gemcitabine chemotherapy in patients with platinum- resistant recurrent ovarian carcinoma.
BACKGROUND
The aim of this study was to explore the efficacy and adverse reactions of CT-guided radioactive 125I-seed implantation treatment combined with chemotherapy for platinum-resistant recurrent ovarian carcinoma.


METHODS
From September 2010 to December 2012, 23 patients with platinum-resistant recurrent ovarian carcinoma were enrolled. All the patients refused, could not bear, or were not suitable for surgery. They all had no more than 3 lesions, which were detected and could also be measured by CT. All were clarified as single-lesion or multiple-lesion groups. A total of 41 lesions underwent implantation of from 8 to 106 125I seeds (median=43). Multi-plane implanting was adopted and 125I-seeds of (0.4-0.7)mCi were placed at intervals of (0.5-1.0) cm. After implantation treatment, all patients underwent 4 cycles of chemotherapy with gemcitabine 800 mg/m2 (days 1, 8 and 15).


RESULTS
The outcome was evaluated with CT 3 weeks and every 3 months after implantation treatment. After 6 months, the volume of 32 out of 41 lesions (78.0%) was reduced at least 30%, within which 9 lesions completely disappeared(22.0%). Complete response was observed in 7 cases (30.4%), with a partial response in 4 cases (17.4%),4 cases stable(17.4%)and 8 cases showing progression (34.8%). The total clinical remission rate was 47.8% (11/23). The clinical remission rate was 77.8% (7/9) in the single-lesion group and 28.6% (4/14) in the multiple-lesion group with a significant difference between the two(P=0.036). The common side effects observed were mild gastrointestinal reactions.


CONCLUSIONS
125I-seed implantation combined with chemotherapy applies an effective way in the treatment of platinum-resistant recurrent ovarian epithelial carcinoma with the advantages of high local control rates, good short-term effects, little trauma and less side effects.
School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, The Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, China E-mail : llh9821@163.com; liuqian1976@msn.com.
Hui
H
Yang
Yu-Hui
YH
Liu
Liang
L
Xu
Li-Heng
LH
Liu
D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000628:therapy; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D001918:Brachytherapy; D059248:Chemoradiotherapy; D018284:Cystadenocarcinoma, Serous / Q000473:pathology / Q000628:therapy; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm / Q000187:drug effects* / Q000528:radiation effects*; D016889:Endometrial Neoplasms / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000628:therapy*; D010984:Platinum / Q000494:pharmacology*; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D007457:Iodine Radioisotopes; D003841:Deoxycytidine; D010984:Platinum; D000093542:Gemcitabine