Combination of 125I brachytherapy and chemotherapy for unresectable recurrent breast cancer

Abstract

Recurrent breast cancer remains an incurable malignancy and cannot be removed by surgery in the majority of cases. This study aimed to explore the feasibility and efficacy of the combination of 125I brachytherapy and chemotherapy for the treatment of unresectable recurrent breast cancer. Patients with unresectable recurrent breast cancer treated between January 2011 and December 2014 with a combination of 125I brachytherapy and capecitabine or gemcitabine were evaluated and outcomes were compared with those of women treated with capecitabine or gemcitabine in conventional dose as a monotherapy. Of 61 patients evaluated, 28 received the combination treatment and 33 received capecitabine or gemcitabine monotherapy. The combination of 125I brachytherapy and chemotherapy resulted in a significant improvement in progression-free survival versus capecitabine or gemcitabine monotherapy (median, 17.8 vs 11.4 months; hazard ratio [HR], 0.44; 95% confidence interval [CI], 0.23–0.84; P = 0.013). The objective response rate (ORR) was significantly higher with the combination (82.1%) than with monotherapy (54.5%; P = 0.022), and the rate of pain relief was higher in the combination arm (100% vs 73.6%; P = 0.038). There was no significant improvement for overall survival (median, 30.1 vs 27.2 months; HR, 0.82; 95% CI, 0.47–1.44; P = 0.496). There were no serious complications detected during the follow-up period, any grade toxicities were comparable between treatment arms. In conclusion, the combination of 125I brachytherapy and second-line chemotherapy is superior to chemotherapy alone and is an effective and safe therapy for unresectable recurrent breast cancer. However, further investigation and much larger scale randomized controlled trials with long-term follow-up are needed.

Monte Carlo study on the gold and gadolinium nanoparticles radio-sensitizer effect in the prostate 125I seeds radiotherapy

“…In the case of DEF of gold and gadolinium nano-particles in the brachytherapy, some paper has been published [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. The studies show that for low energy sources, DEF of nanoparticles is higher than high energy sources.…”

“…Application of the radio-sensitization agents may make the method better. Some others studied 125 I brachytherapy in different organs seated malignancies [15][16][17]. Our aim in this study was to the characterization of 125 I brachytherapy seed radiation and dose in the prostate brachytherapy in the presence of some gold and gadolinium nano-particles.…”

Evaluation of therapeutic effects of 125I particles brachytherapy for recurrent bladder cancer

“…125 I particle implantation-assisted radiotherapy for the treatment of bladder cancer is optimal compared to in vitro irradiation treatment, and especially applicable to patients for whom surgery is not possible. 125 I particles are capable of killing the tumor cells directly, and are not affected by the oxygen content in tumor cells ( 22 , 23 ). Owing to the accurate localization, the local effective dose is large, but the radiation distance is small, the radiation damage is slight, and there is no obvious adverse effect on the surrounding tissue.…”

Radioactive 125I Seed Implantation for Recurrent Cervical Carcinoma After Surgery and Radiotherapy: A Case Report

“…In recent years, 125 I seed implantation therapy has achieved good results in a variety of recurrent tumors due to its advantages of administering a high local dose, reducing the dose to surrounding normal tissue and reducing tumor reproliferation [4][5][6]. The present case concerning recurrence of cervical cancer involved radioactive 125 I seed brachytherapy in combination with paclitaxel and cisplatin chemotherapy.…”