CT-guided permanent 125I seed interstitial brachytherapy for recurrent retroperitoneal lymph node metastases after external beam radiotherapy

Yao, Le; Jiang, Yuliang; Jiang, Ping; Wang, Hao; Meng, Na; Qu, Ang; Tian, Suqing; Sun, Haitao; Liu, Chen; Wang, Junjie; Zhang, Kaixian

doi:10.1016/j.brachy.2015.05.008

Cited by 25 publications

(19 citation statements)

References 34 publications

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“…The dose within PTV should achieve 95% of the prescribed dose (Vl00 > 95%). According to our previous research experience, the prescription dose was 120 (110-140) Gy [15,19,21]. Fused lymph nodes means multiple lymph nodes (2-5) merge into one large lymph node.…”

Section: Brachytherapymentioning

confidence: 99%

“…Due to their complex anatomical location, retroperitoneal metastatic lymph nodes are more suitable for this minimally invasive and safe 125 I brachytherapy. Previously few studies have applied 125 I brachytherapy for retroperitoneal metastatic lymph nodes [19,20]. Therefore, this study was designed to explore the clinical efficacy and prognostic factors of CT-guided 125 I brachytherapy for the treatment of retroperitoneal metastatic lymph nodes.…”

Section: Introductionmentioning

confidence: 99%

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Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

et al. 2020

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Background: Due to the unique anatomical location of retroperitoneal metastatic lymph nodes, current treatment options are limited. This study was designed to explore the clinical efficacy and prognostic factors of CT-guided 125 I brachytherapy for the treatment of retroperitoneal metastatic lymph nodes. Methods:We retrospectively evaluated 92 patients received 125 I brachytherapy for retroperitoneal metastatic lymph nodes. A layered Cox proportional hazards model was established to filter out the independent factors affecting local tumor progression-free survival (LTPFS).Results: The median LTPFS was 8 months. Metastatic lymph node with uniform density (p-0.009), clear boundaries (p-0.011), regular morphology (P < 0.001), and < 3 organs at risk of metastasis (p-0.020) were associated with better LTPFS. Necrotic lymph nodes (p < 0.001), fusion (p-0.003), and invasion of vessels visible on images (p < 0.001) were associated with poor LTPFS. Puncture path through abdominal wall or paravertebral approach were also associated with better LTPFS than a hepatic approach (P < 0.05). A maximum diameter ≤ 3 cm (P-0.031) or 3-5 cm (P-0.018) were also associated with significantly better LTPFS than a maximum diameter ≥ 5 cm. The Cox proportional hazards model suggested that lymph nodes invaded the large vessels visible on images, maximum diameter and puncture path were independent risk factors for LTPFS.Conclusion: CT-guided 125 I brachytherapy is an optional palliative treatment modality for retroperitoneal metastatic lymph nodes, which can provide high local control without severe complications. Better preoperative planning, intraoperative implementation, better choice of puncture path, and selection of appropriate tumor size are important factors that can improve the clinical efficacy of 125 I brachytherapy for retroperitoneal metastatic lymph nodes.

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Section: Brachytherapymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

et al. 2020

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“…The 125 I seed is a miniature radioactive source; it continuously delivers low doses of x-rays and γ-rays, and the radiation dose decreases rapidly with increasing distance from the source [15]. This characteristic makes it possible for CT-guided 125 I brachytherapy to completely cover the therapeutic target area avoiding damage to the adjacent normal tissues [16], [17]. However, to date our study is the first to report on the treatment of distant metastases to the oral and maxillofacial regions using the 125 I brachytherapy modality.…”

Section: Introductionmentioning

confidence: 99%

CT-guided 125I brachytherapy in the treatment of distant metastases in the oral cavity and maxillofacial region

Yan

Xiang²,

Zhong³

et al. 2017

Translational Oncology

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PURPOSE: We aimed to evaluate the feasibility and clinical effectiveness of CT-guided 125I brachytherapy for distant oral and maxillofacial metastases. MATERIALS AND METHODS: We retrospectively analyzed 65 patients with 84 distant oral and maxillofacial metastases. Thirty-one patients with 38 lesions received 125I brachytherapy (group A) and 34 with 46 lesions received external beam radiotherapy (EBRT; group B). RESULTS: Median follow-up time was 16 months. The 3-, 6-, 12-, 18-, and 24-month local control rates for group A were 83.9%, 75.9%, 66.7%, 38.4%, and 25.0%, respectively; for group B they were 76.5%, 62.5%, 43.8%, 25.0%, and 0.0%, respectively (P < .05); the median local tumor progression-free survival times were 14 and 9 months, respectively. Group A had a better local tumor progression-free survival (LTPFS) relative to group B (P < .001; HR, 6.961 [95%CI, 2.109, 9.356]). Cox proportional hazards regression analysis indicated that 125I brachytherapy, tumor size, and primary pathological type were the independent factors affecting LTPFS. Additionally, 125I brachytherapy showed better performance in relieving patient clinical symptoms relative to EBRT (P < .05). Group A also had fewer complications than group B, especially regarding grade 3/4 complications according to Radiation Therapy Oncology Group grading criteria. Mean overall survival times in groups A and B were 17.1 and 14.8 months, respectively. CONCLUSION: CT-guided 125I brachytherapy is feasible and safe for distant oral and maxillofacial metastases; it achieved a better local control rate, longer LTPFS and fewer complications without compromising overall survival compared with EBRT.

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“…Previously, we have reported the possibility of 125 I seed interstitial brachytherapy for the salvage treatment of recurrent lymph node metastases [19, 20], rectal carcinoma [21], pancreatic carcinoma [22], soft tissue sarcoma [23], and primary spinal tumors [24]; yet, there have rarely been reports on its use for spinal metastases after EBRT. Therefore, the aim of this study was to review our preliminary experience with this salvage therapy in patients with recurrent spinal metastases after EBRT in the reirradiation setting and to evaluate the feasibility, safety, and clinical efficacy of this technology.…”

Section: Introductionmentioning

confidence: 99%

CT-Guided ¹²⁵I Seed Interstitial Brachytherapy as a Salvage Treatment for Recurrent Spinal Metastases after External Beam Radiotherapy

Yao

Cao

Wang

et al. 2016

BioMed Research International

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The aim of this study is to evaluate the feasibility, safety, and clinical efficacy of CT-guided 125I 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 before 125I seed interstitial brachytherapy; dosimetry verification was performed immediately after seed implantation. Median actual D 90 was 99 Gy (range, 90–176), and spinal cord median D max was 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-guided 125I seed interstitial brachytherapy appears to be feasible, safe, and effective as pain relief or salvage treatment for patients with recurrent spinal metastases after EBRT.

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CT-guided permanent 125I seed interstitial brachytherapy for recurrent retroperitoneal lymph node metastases after external beam radiotherapy

Cited by 25 publications

References 34 publications

Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

CT-guided 125I brachytherapy in the treatment of distant metastases in the oral cavity and maxillofacial region

CT-Guided ¹²⁵I Seed Interstitial Brachytherapy as a Salvage Treatment for Recurrent Spinal Metastases after External Beam Radiotherapy

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CT-guided permanent 125I seed interstitial brachytherapy for recurrent retroperitoneal lymph node metastases after external beam radiotherapy

Cited by 25 publications

References 34 publications

Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

CT-guided 125I brachytherapy in the treatment of distant metastases in the oral cavity and maxillofacial region

CT-Guided 125I Seed Interstitial Brachytherapy as a Salvage Treatment for Recurrent Spinal Metastases after External Beam Radiotherapy

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CT-Guided ¹²⁵I Seed Interstitial Brachytherapy as a Salvage Treatment for Recurrent Spinal Metastases after External Beam Radiotherapy