Efficacy and safety of CT-guided 125I seed implantation as a salvage treatment for locally recurrent head and neck soft tissue sarcoma after surgery and external beam radiotherapy: A 12-year study at a single institution

Abstract

The objective of this study was to evaluate the efficacy and safety of CT-guided radioactive 125 I seed implantation as a salvage treatment for locally recurrent head and neck soft tissue sarcoma (HNSTS) after surgery and external beam radiotherapy. METHODS AND MATERIALS: From December 2006 to February 2018, 25 patients with locally recurrent HNSTS after surgery and external beam radiotherapy were enrolled. All the patients successfully underwent CT-guided 125 I seed implantation. The primary end points included the objective response rate (ORR) and local progression-free survival (LPFS). The secondary end points were survival (OS) and safety profiles. RESULTS: After 125 I seed implantation, the ORR was 76.0%. The 1-, 3-, and 5-year LPFS rates were 65.6%, 34.4%, and 22.9%, respectively, with the median LPFS of 16.0 months. The 1-, 3-, and 5-year OS rates were 70.8%, 46.6%, and 34.0%, respectively, with the median OS of 28.0 months. Furthermore, univariate analyses showed that the recurrent T stage and histological grade were prognostic factors of LPFS, whereas only the histological grade was a predictor of OS. The major adverse events were skin/mucosal toxicities, which were generally of lower grade (#Grade 2) and were well tolerated. CONCLUSIONS: Radioactive 125 I seed implantation could be an effective and safe alternative treatment for locally recurrent HNSTS after failure of surgery and radiotherapy. Recurrent T stage and histological grade were the main factors influencing the efficacy.

Oligorecurrence Non–small Cell Lung Cancer After Failure of First-Line Chemotherapy: Computed Tomography–Guided 125I Seed Implantation vs. Second-Line Chemotherapy

“…125 I brachytherapy can deliver high radiation dose, because of accumulated radiation dose delivered continuously by 125 I seeds and localized in the target tumor. Therefore, the adjacent normal tissues could be spared (16). However, a few complications associated with needle puncture should be noticed.…”

“…And the total number and activity of seed to be implanted were calculated via the modified level formula (22) (Figure 1B). The dosimetric goal was that the dose received by 90% of the GTV should reach the prescription dose as much as possible, and the doses delivered to the adjacent normal organs were as low as possible (16).…”

“…Radioactive 125 I seed (RIS) brachytherapy recently has been a standard treatment in early low-to intermediate-risk prostate cancer (16,17). It is a type of low-dose-rate brachytherapy, which could deliver high radiation dose to target tumor while safely sparing the adjacent normal tissue.…”

“…Previous studies indicated that 125 I brachytherapy is a feasible salvage treatment method for many cancers, including prostate cancer, lung cancer, pancreatic cancer, and head and neck cancer (18). To a certain extent, RIS implantation brachytherapy is similar to a single dose of stereotactic ablative radiotherapy and can also be called "stereotactic ablative brachytherapy" (16). However, whether RIS implantation could provide benefits in terms of local control and survival to oligorecurrence NSCLC patients after failure of first-line chemotherapy remains unclear.…”

The Accuracy of Individualized 3D-Printing Template-Assisted I125 Radioactive Seed Implantation for Recurrent/Metastatic Head and Neck Cancer

“…Thus, both The Head and Neck Working Group of the European Brachytherapy Group and the American Brachytherapy Society recommended BT as one of the treatments for head and neck cancers (3,4). As the mainstay of BT, I 125 radioactive seed implantation (RSI) was reported to be safe and effective for recurrent/metastatic head and neck cancer as salvage therapy (5)(6)(7)(8).…”