title: (125)I Seed Permanent Implantation as a Palliative Treatment for Stage III and IV Hypopharyngeal Carcinoma.
abstract: OBJECTIVE
  The aim of this study was to investigate the feasibility and safety of percutaneous (125)I seed permanent implantation for advanced hypopharyngeal carcinoma from toxicity, tumor response, and short-term outcome.
  
  
  METHODS
  (125)I seeds implant procedures were performed under computed tomography for 34 patients with advanced hypopharyngeal carcinoma. We observed the local control rate, overall survival, and acute or late toxicity rate.
  
  
  RESULTS
  In the 34 patients (stage III, n=6; stage IV, n=28), the sites of origin were pyriform sinus (n=29) and postcricoid area (n=5). All patients also received one to four cycles of chemotherapy after seed implantation. The post-plan showed that the actuarial D90 of (125)I seeds ranged from 90 to 158 Gy (median, 127 Gy). The mean follow-up was 12.3 months (range, 3.4 to 43.2 months). The local control was 2.1-31.0 months with a median of 17.7 months (95% confidence interval [CI], 13.4 to 22.0 months). The 1-, 2-, and 3-year local controls were 65.3%, 28.6%, and 9.5% respectively. Twelve patients (35%) died of local recurrence, fourteen patients (41%) died of distant metastases, and three patients (9%) died of recurrence and metastases at the same time. Five patients (15%) still survived to follow-up. At the time of analysis, the median survival time was 12.5 months (95% CI, 9.5 to 15.4 months). The 1-, 2-, and 3-year overall survival rates were 55.2%, 20.3%, and 10.9%, respectively. Five patients (15%) experienced grade 3 toxic events and nine patients (26%) have experienced grade 2 toxic events.
  
  
  CONCLUSIONS
  This review shows relatively low toxicity for interstitial (125)I seed implantation in the patients with advanced stage hypopharyngeal cancer. The high local control results suggest that (125)I seed brachytherapy implant as a salvage or palliative treatment for advanced hypopharyngeal carcinoma merit further investigation.
authors.affiliation: Head and Neck Tumor Research Center, No. 3 Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Li
authors.affiliation: Head and Neck Tumor Research Center, No. 3 Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yang
authors.affiliation: Head and Neck Tumor Research Center, No. 3 Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Xiaojiang
authors.initials: X
authors.lastname: Li
authors.affiliation: Radiation Therapy Research Center, No. 3 Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Wang
authors.affiliation: Head and Neck Tumor Research Center, No. 3 Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Yanxin
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Head and Neck Tumor Research Center, No. 3 Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Jimin
authors.initials: J
authors.lastname: Fei
authors.affiliation: Head and Neck Tumor Research Center, No. 3 Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xi
authors.affiliation: Head and Neck Tumor Research Center, No. 3 Affiliated Hospital of Kunming Medical University, Kunming, China.
authors.forename: Ruimei
authors.initials: R
authors.lastname: Sun
authors.affiliation: Department of ENT, Kunming City Children's Hospital, Kunming, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Ma
keywords: Brachytherapy; Hypopharyngeal neoplasms; Palliative care