title: Palliative treatment of pelvic bone tumors using radioiodine (125I) brachytherapy.
abstract: BACKGROUND
  Complete resection of pelvic bone tumors, especially recurrent and metastatic ones, is often impossible to achieve using conventional surgery. This study aimed to assess the benefits and adverse effects of computed tomography (CT)-guided radioiodine (125I) brachytherapy for inoperable recurrent and metastatic bone tumors of the pelvis.
  
  
  METHODS
  This was a retrospective study of 22 patients with confirmed pelvic bone tumors (10 females and 12 males; 15-84 years; 21 with primary pelvic tumor and one with pelvic metastasis). CT-guided125I brachytherapy was performed using 9-21125I seeds (radioactivity of 0.5-0.7 mCi). Seed implantation was validated by postoperative CT scanning. Complications, pain, survival, and CT-estimated tumor size were carried out to evaluate the therapeutic benefits.
  
  
  RESULTS
  Postoperative CT scans revealed satisfactory125I seed implantation, and the radiation dose delivered to 90% of the target area (D90) was higher than the prescription dose (PD). No obvious complications were observed. Pain was reported by 19 of 22 patients, but 17 reported pain relief after implantation. Follow-up ranged 8-27 (median, 19) months. Tumor size was reduced in 11 patients within 1 month after surgery, nine patients showed no change, and tumor size increased in two patients. Finally, 1- and 2-year survival was 81.8 and 45.5%, respectively; 1- and 2-year local tumor control rates were 59.1 and 36.4%, respectively.
  
  
  CONCLUSIONS
  125I seed implantation significantly reduced bone tumor size and relieved pain, with a low complication rate. These findings suggest that125I brachytherapy treatment could be a useful palliative approach for pelvic bone tumor treatment.
authors.affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
authors.forename: Chongren
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China.
authors.forename: Zhengqi
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Orthopedic Oncology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.|Shanghai Bone Tumor Institution, Shanghai, 201620, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Sun
authors.affiliation: Department of Spine Surgery, Xinjiang People's Hospital, Urumqi, Xinjiang Autonomous Region, 830001, China.
authors.forename: Yisilamu
authors.initials: Y
authors.lastname: Yasin
authors.affiliation: Department of Orthopedics, Huashan Hospital Baoshan Branch Affiliated to Fudan University, Shanghai, 200431, China.
authors.forename: Chuanyin
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Orthopedic Oncology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Ma
authors.affiliation: Orthopedic Oncology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: Orthopedic Oncology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China.
authors.forename: Jiakang
authors.initials: J
authors.lastname: Shen
authors.affiliation: Orthopedic Oncology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China. zhdcai@126.com.|Shanghai Bone Tumor Institution, Shanghai, 201620, China. zhdcai@126.com.
authors.forename: Yingqi
authors.initials: Y
authors.lastname: Hua
authors.affiliation: Orthopedic Oncology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China. czd856@vip.163.com.|Shanghai Bone Tumor Institution, Shanghai, 201620, China. czd856@vip.163.com.
authors.forename: Zhengdong
authors.initials: Z
authors.lastname: Cai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D000072716:Cancer Pain / Q000532:radiotherapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D010384:Pelvic Bones / Q000473:pathology / Q000528:radiation effects*; D011829:Radiation Dosage; D011881:Radiotherapy, Computer-Assisted / Q000009:adverse effects / Q000379:methods*; D061089:Radiotherapy, Image-Guided / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes
keywords: 125I seed; Brachytherapy; Efficacy; Pelvic tumor; Safety