Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 7/2010

01-07-2010 | Interventional

Clinical efficacy of CT-guided iodine-125 seed implantation therapy in patients with advanced pancreatic cancer

Authors: Wang Zhongmin, Liu Yu, Liu Fenju, Chen Kemin, Huang Gang

Published in: European Radiology | Issue 7/2010

Login to get access

Abstract

Objective

To examine the clinical efficacy of CT-guided radioactive iodine-125 (125I) seeds implantation treatment in patients with unresectable pancreatic cancer.

Methods

Thirty-one patients with inoperable pancreatic cancer were enrolled in this study. The 125I seeds were implanted into pancreatic tumor under CT guidance. In addition, 10 patients received routine gemcitabine and 5-fluorouracil chemotherapy 1 week after brachytherapy. Median diameter of the tumor was 5.8 cm.

Results

Follow-up period was 2 to 25 months. Symptoms of refractory pain were significantly resolved post-interventionally (P < 0.05), and Karnofsky physical score increased dramatically (P < 0.05). Tumor response which was demonstrated on repeated CT film 2 months post-treatment revealed complete response (CR) in 3 cases, partial response (PR) in 16 cases, stable disease (SD) in 9 cases, and progressive disease (PD) in 3 cases. Overall responding rate (CR+PR) was 61.3%. Median survival time for all patients was 10.31 months. Two seeds of radioactive 125I migrated to the liver in 2 patients. There were no serious complications detected during the follow-up period.

Conclusions

This study suggests that CT-guided brachytherapy using 125I seeds implantation appears to be safe, effective, uncomplicated, and could produce adequate pain relief for treating unresectable pancreatic cancer.
Literature
1.
Geer RJ, Brennan MF (1993) Prognostic indicators for survival after resection of pancreatic adenocarcinoma. Am J Surg 165:68–73CrossRefPubMed
2.
Minsky BD, Hilaris B, Fuks Z (1988) The role of radiation therapy in the control of pain from pancreatic carcinoma. J Pain Symptom Manage 3:199–205CrossRefPubMed
3.
Nag S, DeHaan M, Scruggs G et al (2006) Long-term follow-up of patients of intrahepatic malignancies treated with iodine-125 brachytherapy. Int J Radiat Oncol Biol Phys 64:736–744PubMed
4.
Ebara S, Katayama N, Tanimoto R et al (2008) Iodine-125 seed implantation (permanent brachytherapy) for clinically localized prostate cancer. Acta Med Okayama 62:9–13PubMed
5.
Volmar KE, Vollmer RT, Jowell PS et al (2005) Pancreatic FNA in 1000 cases: a comparison of imaging modalities. Gastrointest Endosc 61:854–861CrossRefPubMed
6.
Gupta S, Ahrar K, Morello FA Jr et al (2002) Masses in or around the pancreatic head: CT-guided coaxial fine-needle aspiration biopsy with a posterior transcaval approach. Radiology 222:63–69CrossRefPubMed
7.
Dickey JE, Haaga JR, Stellato TA et al (1986) Evaluation of computed tomography guided percutaneous biopsy of the pancreas. Surg Gynecol Obstet 163:497–503PubMed
8.
Mueller PR (1993) Pancreatic biopsy: striving for excellence. Radiology 187:15–16PubMed
9.
Brandt KR, Charboneau JW, Stephens DH et al (1993) CT- and US-guided biopsy of the pancreas. Radiology 187:99–104PubMed
10.
Freelove R, Walling AD (2006) Pancreatic cancer: diagnosis and management. Am Fam Physician 73:485–492PubMed
11.
Chen HH, Jia RF, Yu L, Zhao MJ, Shao CL, Cheng WY (2008) Bystander effects induced by continuous low-dose-rate 125I seeds potentiate the killing action of irradiation on human lung cancer cells in vitro. Int J Radiat Oncol Biol Phys 72:1560–1566PubMed
12.
Cengiz M, Gurdalli S, Selek U et al (2008) Effect of bladder distension on dose distribution of intracavitary brachytherapy for cervical cancer: three-dimensional computed tomography plan evaluation. Int J Radiat Oncol Biol Phys 70:464–468PubMed
13.
Monk BJ, Tewari KS, Puthawala AA et al (2002) Treatment of recurrent gynecologic malignancies with iodine-125 permanent interstitial irradiation. Int J Radiat Oncol Biol Phys 52:806–815CrossRefPubMed
14.
Burris HA, Moore MJ, Andersen J et al (1997) Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol 15:2403–2413PubMed
15.
Hwang SS, Scott CB, Chang VT et al (2004) Prediction of survival for advanced cancer patients by recursive partitioning analysis: role of Karnofsky performance status, quality of life, and symptom distress. Cancer Invest 22:678–687CrossRefPubMed
16.
Miller AB, Hoogstraten B, Staquet M et al (1981) Reporting results of cancer treatment. Cancer 47:207–214CrossRefPubMed
17.
Barkin JS, Goldstein JA (2000) Diagnostic and therapeutic approach to pancreatic cancer. Biomed Pharmacother 54:400–409CrossRefPubMed
18.
Geer RJ, Brennan MF (1993) Prognostic indicators for survival after resection of pancreatic adenocarcinoma. Am J Surg 165:68–72CrossRefPubMed
19.
Morrow M, Hilaris B, Brennan MF (1984) Comparison of conventional surgical resection, radioactive implantation, and bypass procedures for exocrine carcinoma of the pancreas 1975–1980. Ann Surg 199:1–5CrossRefPubMed
20.
Xie DR, Liang HL, Wang Y et al (2006) Meta-analysis on inoperable pancreatic cancer: a comparison between gemcitabine-based combination therapy and gemcitabine alone. World J Gastroenterol 12:6973–6981PubMed
21.
Peretz T, Nori D, Hilaris B et al (1989) Treatment of primary unresectable carcinoma of the pancreas with 1–125 implantation. Int J Radiat Oncol Biol Phys 17:931–935PubMed
22.
Chen A, Galloway M, Landreneau R et al (1999) Intraoperative 125I brachytherapy for high-risk stage I non-small cell lung carcinoma. Int J Radait Oncol Bio Phys 44:1057–1063
23.
Trombetta MG, Colonias A, Makishi D et al (2008) Tolerance of the aorta using intraoperative iodine-125 interstitial brachytherapy in cancer of the lung. Brachytherapy 7:50–54CrossRefPubMed
24.
Armstrong JG, Anderson LL, Harrison LB (1994) Treatment of liver metastases from colorectal cancer with radioactive implants. Cancer 73:1800–1804CrossRefPubMed
25.
Cron GO, Beghein N, Crokart N et al (2005) Changes in the tumor microenvironment during low-dose-rate permanent seed implantation iodine-125 brachytherapy. Int J Radiat Oncol Biol Phys 63:1245–1251PubMed
Metadata
Title
Clinical efficacy of CT-guided iodine-125 seed implantation therapy in patients with advanced pancreatic cancer
Authors
Wang Zhongmin
Liu Yu
Liu Fenju
Chen Kemin
Huang Gang
Publication date
01-07-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 7/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-009-1703-0

Other articles of this Issue 7/2010

European Radiology 7/2010 Go to the issue

Contrast Media

The fate of Gd and chelate following intravenous injection of gadodiamide in rats

Head and Neck

Value of MR imaging in the differentiation of benign and malignant orbital tumors in adults

Letter to the Editor

Letter to the Editor re: Evolution of emphysema in relation to smoking

Chest

Widening of coronary sinus in CT pulmonary angiography indicates right ventricular dysfunction in patients with acute pulmonary embolism

Reply

Reply to Letter to the Editor re: Evolution of emphysema in relation to smoking

Interventional

Persistent postpartum haemorrhage after failed arterial ligation: value of pelvic embolisation