title: CT-guided implantation of (125)I seeds (permanent brachytherapy) for metastatic tumors of the hepatic portal system: Effectiveness and safety in 13 patients.
abstract: OBJECTIVE
  To retrospectively evaluate the efficacy and safety of CT-guided implantation of (125)I seeds (permanent brachytherapy) for metastatic tumors of the hepatic portal system (HPS).
  
  
  METHODS
  Between January 2012 and January 2015, 13 patients with metastases measuring >3.0 cm in short-axis diameter, which remained in the HPS after conventional chemotherapy and/or transcatheter arterial chemoembolization, and for which an effective therapeutic dose from external beam radiotherapy could not be delivered, received CT-guided (125)I brachytherapy. Clinical data were studied retrospectively. In terms of metrological requirements, the minimum dose to 90% of the target volume (D90) was 90-160 Gy for (125)I seeds with activity of 2.96 × 10(7)Bq. CT-based evaluation after 2, 4, and 8 weeks, as well as 6 months after implantation enabled review of local control of tumors.
  
  
  RESULTS
  All symptoms were improved after (125)I brachytherapy. The mean value for D90 for implantation of (125)I seeds was 136 Gy. Complete response (CR) + partial response (PR) was documented in 61.5%, 69.2%, and 84.6% of patients at 2 weeks, 4 weeks, and 6 months after implantation, respectively. Four of 13 patients had complete response, 7 cases had PR, 1 patient had stable disease, and 1 case had progressive disease. All metastatic foci were controlled by implantation. No serious complications were observed.
  
  
  CONCLUSIONS
  CT-guided (125)I brachytherapy is a safe and effective treatment for metastatic tumors of the HPS and can achieve good local control in the short term as long as the radiation dose is sufficient. CT-guided (125)I brachytherapy carries few complications, is simple, safe, and a good complement to cancer treatment.
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Jiangsu Province, Suzhou, China; Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital), Jiangsu Province, Wuxi, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital), Jiangsu Province, Wuxi, China.
authors.forename: Qigen
authors.initials: Q
authors.lastname: Xie
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital), Jiangsu Province, Wuxi, China.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital), Jiangsu Province, Wuxi, China.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Hua
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital), Jiangsu Province, Wuxi, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital), Jiangsu Province, Wuxi, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Jiangsu Province, Suzhou, China. Electronic address: 759853297@qq.com.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011168:Portal System; D015641:Radiography, Interventional / Q000379:methods; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary
chemical_list: D007457:Iodine Radioisotopes
keywords: Brachytherapy; Computed tomography guided; Iodine-125; Metastasis tumor; Portal hepatic