¹²⁵I Seed Permanent Implantation as a Palliative Treatment for Stage III and IV Hypopharyngeal Carcinoma

Abstract

Objectives.The aim of this study was to investigate the feasibility and safety of percutaneous 125I seed permanent implantation for advanced hypopharyngeal carcinoma from toxicity, tumor response, and short-term outcome.Methods.125I seeds implant procedures were performed under computed tomography for 34 patients with advanced hypopharyngeal carcinoma. We observed the local control rate, overall survival, and acute or late toxicity rate.Results.In the 34 patients (stage III, n=6; stage IV, n=28), the sites of origin were pyriform sinus (n=29) and postcricoid area (n=5). All patients also received one to four cycles of chemotherapy after seed implantation. The post-plan showed that the actuarial D90 of 125I seeds ranged from 90 to 158 Gy (median, 127 Gy). The mean follow-up was 12.3 months (range, 3.4 to 43.2 months). The local control was 2.1–31.0 months with a median of 17.7 months (95% confidence interval [CI], 13.4 to 22.0 months). The 1-, 2-, and 3-year local controls were 65.3%, 28.6%, and 9.5% respectively. Twelve patients (35%) died of local recurrence, fourteen patients (41%) died of distant metastases, and three patients (9%) died of recurrence and metastases at the same time. Five patients (15%) still survived to follow-up. At the time of analysis, the median survival time was 12.5 months (95% CI, 9.5 to 15.4 months). The 1-, 2-, and 3-year overall survival rates were 55.2%, 20.3%, and 10.9%, respectively. Five patients (15%) experienced grade 3 toxic events and nine patients (26%) have experienced grade 2 toxic events.Conclusion.This review shows relatively low toxicity for interstitial 125I seed implantation in the patients with advanced stage hypopharyngeal cancer. The high local control results suggest that 125I seed brachytherapy implant as a salvage or palliative treatment for advanced hypopharyngeal carcinoma merit further investigation.

CT-Guided 125 I Brachytherapy for Locally Recurrent Nasopharyngeal Carcinoma

“…125 I brachytherapy has been successfully used in tongue cancer, hypopharyngeal cancer, salivary adenocarcinoma, intracranial tumors (26)(27)(28) . Huang et al reported 125 I brachytherapy for cervical lymph node metastasis of head and neck cancer, the 1-, and 2-years local control rate were 64.51% and 45.16%, respectively (29) .…”

Efficacy and prognosis of CT-guided of 125I radioactive seeds implantation brachytherapy as salvage treatment for recurrent nasopharyngeal carcinoma after external beam radiotherapy--A long-term experience at a single institution

“…I RSI-BT, one of the most common brachytherapy, was often chosen as a salvage treatment for recurrent cancers, such as hypopharyngeal carcinoma38 , salivary gland carcinoma39 or other head and neck squamous cell carcinoma40 . Because of its sharp dose curve, 125 I RSI-BT could protect OARs and achieve a higher local dose distribution so as to achieve favorable LC.…”