CT-Guided ¹²⁵I 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-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.

Accuracy and dosimetric parameters comparison of 3D-printed non-coplanar template-assisted computed tomography-guided iodine-125 seed ablative brachytherapy in pelvic lateral recurrence of gynecological carcinomas

“…With the development of 125 I-SAB, its advantage of delivering high-dose to the target while sparing the surrounding normal tissues with rapidly dose drop-off, proved 125 I-SAB to be a unique option as a monotherapy or combined with EBRT for cancer treatment [ 29 , 30 , 31 ]. In 2015, CT guidance was integrated into 125 I-SAB, which provided a new salvage solution for recurrent carcinomas after EBRT [ 29 , 30 , 31 , 32 ]. However, the dosimetric patterns in post-operative plan cannot be accurately implemented compared to pre-operative plan requirements under free-hand CT guidance [ 33 ].…”

DLDTI: a learning-based framework for drug-target interaction identification using neural networks and network representation

“…Tetramethylpyrazine (TMPZ) is a member of pyrazines derived from Rhizoma Chuanxiong [ 15 ]. According to a recent review, TMPZ could attenuate atherosclerosis by suppressing lipid accumulation in macrophages [ 16 ], alleviation of lipid metabolism disorder [ 17 ], and attenuation of oxidative stress [ 18 ].…”

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.…”

“…It is associated with some advantages; low energy special design, continuous irradiation and rapid dose drop at a low distance from the source. Different brachytherapy sources with own design have been studied utilizing Monte Carlo (MC) simulation and experimentally by different dosimeters [1][2][3][4][5][6][7]. Among the sources, 125 I seed also has designed and used to cancerous tissue treatment [8][9][10][11][12].…”