title: CT-Guided125I Seed Interstitial Brachytherapy as a Salvage Treatment for Recurrent Spinal Metastases after External Beam Radiotherapy.
abstract: The aim of this study is to evaluate the feasibility, safety, and clinical efficacy of CT-guided125I seed interstitial brachytherapy in patients with recurrent spinal metastases after external beam radiotherapy (EBRT). Between August 2003 and September 2015, 26 spinal metastatic lesions (24 patients) were reirradiated by this salvage therapy modality. Treatment for all patients was preplanned using a three-dimensional treatment planning system 3-5 days before125I seed interstitial brachytherapy; dosimetry verification was performed immediately after seed implantation. Median actualD90was 99 Gy (range, 90-176), and spinal cord medianDmaxwas 39 Gy (range, 6-110). Median local control (LC) was 12 months (95% CI: 7.0-17.0). The 6- and 12-month LC rates were 52% and 40%, respectively. Median overall survival (OS) was 11 months (95% CI: 7.7-14.3); 6-month and 1-, 2-, and 3-year OS rates were 65%, 37%, 14%, and 9%, respectively. Pain-free survival ranged from 2 to 42 months (median, 6; 95% CI: 4.6-7.4). Treatment was well-tolerated, with no radiation-induced vertebral compression fractures or myelopathy reported. Reirradiation with CT-guided125I seed interstitial brachytherapy appears to be feasible, safe, and effective as pain relief or salvage treatment for patients with recurrent spinal metastases after EBRT.
authors.affiliation: Department of Radiation Oncology, Peking University Third Hospital, Hua-Yuan North Road No. 49, Beijing 100191, China.
authors.forename: Lihong
authors.initials: L
authors.lastname: Yao
authors.affiliation: Cancer Center, The Second Hospital of Shandong University, Jinan, Shandong 250033, China.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Cao
authors.affiliation: Department of Radiation Oncology, Peking University Third Hospital, Hua-Yuan North Road No. 49, Beijing 100191, China.
authors.forename: Junjie
authors.identifier: 0000-0002-6277-7531
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Nuclear Medicine, The First Affiliated Hospital of Wannan Medical College, No. 2 Zhe Shan Xi Road, Jinghu District, Wuhu 241001, China.
authors.forename: Jiwen
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Radiation Oncology, Peking University Third Hospital, Hua-Yuan North Road No. 49, Beijing 100191, China.
authors.forename: Na
authors.initials: N
authors.lastname: Meng
authors.affiliation: Department of Radiation Oncology, Peking University Third Hospital, Hua-Yuan North Road No. 49, Beijing 100191, China.
authors.forename: Fuxin
authors.initials: F
authors.lastname: Guo
authors.affiliation: Department of Radiation Oncology, Peking University Third Hospital, Hua-Yuan North Road No. 49, Beijing 100191, China.
authors.forename: Yuliang
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Radiation Oncology, Peking University Third Hospital, Hua-Yuan North Road No. 49, Beijing 100191, China.
authors.forename: Suqing
authors.initials: S
authors.lastname: Tian
authors.affiliation: Department of Radiation Oncology, Peking University Third Hospital, Hua-Yuan North Road No. 49, Beijing 100191, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D061766:Proton Therapy; D061089:Radiotherapy, Image-Guided; D016879:Salvage Therapy; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary; D015996:Survival Rate