Clinical application of computed tomography-guided (125)I seed interstitial implantation for head and neck cancer patients with unmanageable cervical lymph node metastases.
BACKGROUND
To assess clinical application of computed tomography (CT)-guided (125)I seed implantation for patients who cannot endure or unwillingly receive repeated surgery, chemotherapy, or radiotherapy for unmanageable cervical lymph node metastases in head and neck cancer (HNC).


METHODS
Thirty-one consecutive patients received CT-guided (125)I seed implantation between February 2010 and December 2013. To evaluate the clinical efficiency, karnofsky performance score (KPS), numeric rating scale (NRS), and tumor volume at 3-, and 6-month post-implantation were compared with pre-implantation, along with local control rate (LCR), overall survival rate (OSR), and complications at 3, 6 months, 1, and 2 years.


RESULTS
The tumor volume was obviously decreased at 3-, and 6-month post-implantation (21.23 ± 8.83 versus 9.19 ± 7.52 cm(2); 21.23 ± 8.83 versus 6.42 ± 9.79 cm(2); P < 0.05) compared with pre-implantation. The NRS was statistically reduced (3.06 ± 1.06 versus 7.77 ± 0.92; 2.39 ± 1.15 versus 7.77 ± 0.92; P < 0.05), while KPS was significantly improved (83.18 ± 5.97 versus 73.60 ± 7.90; 82.86 ± 5.43 versus 73.60 ± 7.90; P < 0.05) postoperatively at 3 and 6 months, respectively. The LCR at 3, 6 months, 1, and 2 years was 96.30, 83.87, 64.51, and 45.16%, respectively. The OSR was 100, 100, 67.74, and 45.16%, respectively. Three cases experienced grade I and two had grade II acute radiation toxicity.


CONCLUSIONS
CT-guided seed implantation may be feasible and safe for HNC patients whose neck nodes are not manageable by routine strategies with fewer complications, higher LCR, and significant pain relief.
Department of Orthopedic Oncology, The People's Hospital of Liaoning Province, Wenyi Street No. 33, Shenyang, 110016, China. haihuanghh@163.com.
Hai
H
Huang
Department of Orthopedic Oncology, The People's Hospital of Liaoning Province, Wenyi Street No. 33, Shenyang, 110016, China.
Shaonian
S
Xu
Department of Orthopedic Oncology, The People's Hospital of Liaoning Province, Wenyi Street No. 33, Shenyang, 110016, China.
Fusheng
F
Li
Department of Orthopedic Oncology, The People's Hospital of Liaoning Province, Wenyi Street No. 33, Shenyang, 110016, China.
Zhenguang
Z
Du
Department of Orthopedic Oncology, The People's Hospital of Liaoning Province, Wenyi Street No. 33, Shenyang, 110016, China.
Liang
L
Wang
D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000528:radiation effects*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D047368:Tumor Burden / Q000528:radiation effects
D007457:Iodine Radioisotopes
CT-guided 125I seed; Cervical lymph node metastasis; Head and neck cancer; Interstitial implantation