Evaluation of the efficacy of CT-guided 3D template-assisted 125I seed implantation in the treatment of unresectable STS: a multicenter retrospective study

Abstract

To observe the safety and efficacy of CT-guided 3D template-assisted radioactive 125I seed implantation in the treatment of unresectable advanced soft tissue sarcoma (STS). Sixty-two patients who underwent continuous 3D template-assisted radioactive 125I seed implantation for the treatment of unresectable advanced STS from August 2017 to August 2018 were selected from four tumor treatment centers for retrospective analysis. The postoperative adverse reactions and tumor response were recorded, and the postoperative complications were observed and treated at the same time. The overall survival (OS) rate was determined. All patients successfully completed 125I seed implantation. In practice, the median number of puncture needles used during the operation was 20, and the median number of 125I particles was 88. There were no statistical differences in the relative dosimetry parameters before and after the operation (P > 0.05). Tumor evaluation was performed 6 months after the operation. The effective rate was 61.3%, and the local control rate was 93.5%. As of March 2020, the 1-year survival rate was 85.2%, and the 2-year survival rate was 49.0%. The OS was 23 months. CT-guided 3D template-assisted 125I seed implantation for the treatment of unresectable STS has a high local control rate, thereby further prolonging the OS of patients with unresectable STS.

Research progress on feasibility and dosimetry of 3D printing template-assisted 125I seed implantation in the treatment of malignant tumors

“…Zhao et al [9] found that the application of 3D printing technology made particle implantation more accurate, reduced the number of intraoperative needle adjustments, thereby reducing the complications caused by repeated puncture, and shortening the operation time. Zhao et al [1] conducted a multicenter retrospective analysis of the survival of 62 patients with unresectable advanced soft tissue sarcoma (STS) who had previously received CT-guided 3D template-assisted RISI treatment. The overall survival rate was 23 months.…”

“…In the past, 125 I was implanted based on the experience of the surgeon. If the particle location and dose distribution are significantly different before and after the plan, if multiple needles cannot be inserted into the tumor target as planned, local tumor recurrence and serious complications may eventually occur [1] . In addition, traditional freehand RISI is very complex and time-consuming, and requires a trained surgeon to perform it well.…”