Treatment of central type lung cancer by CT guided percutaneous implants of125I radioisotopes

Xiao-kun, HU; Ming-you, Wang; Yang, Zhiguo; Qiu, Chundong; Lü, Dongfang; Zuo, Taiyang

doi:10.1007/bf02761526

Cited by 6 publications

(6 citation statements)

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“…Percutaneous 125 I seeds implantation has been widely used for treatment of lung cancer, lung metastasis, liver cancer, pancreatic cancer, and soft tissue malignancy. [ 14 15 16 ] Several studies also confirm the value of CT guided 125 I seed implantation for patients with metastatic lymph nodes of the mediastinum integrating the advantages of CT intervention and radiotherapy. [ 17 18 ]…”

Section: Discussionmentioning

confidence: 97%

Experimental Computed Tomography-guided Vena Cava Puncture in Pigs for Percutaneous Brachytherapy of Middle Mediastinal Lymph Node Metastases

Zhao

Liu

et al. 2015

Chinese Medical Journal

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Background:Percutaneous brachytherapy is a valuable method for the treatment of lung cancer and mediastinal lymph nodes metastasis. However, in some of the metastatic lymph nodes in the middle mediastinum, the percutaneous approach cannot be used safely due to possible damage to surrounding anatomical structures. We established an animal model (group of 12 pigs) to assess the safety and feasibility of computed tomography (CT)-guided vena cava puncture.Methods:Under CT guidance, an 18G needle was used to puncture the anterior wall of the anterior vena cava (AVC) in 12 pigs. The 18G needle was chosen as it is similar in size to the needles employed for clinical application in brachytherapy. The incidence of complications and vital signs was monitored during the procedure. Thoracotomy was performed to remove AVC specimens, which were analyzed for histological evidence of vessel wall damage and repair.Results:Following postoperative enhanced CT, two animals were found to have a small pneumothorax (one being hemopneumothorax). The intraoperative oxygen saturation of both animals was not significantly decreased and was maintained at 93–100%. No animals developed mediastinal hematoma. Preoperative, intraoperative, and postoperative changes in blood pressure, heart rate, hemoglobin, and blood oxygen saturation were not significant. Histological evaluation of AVC specimens showed that by 7 days following the procedure, the endothelial layer was smooth with notable scar repair in the muscularis layer.Conclusions:CT performed after the procedure and histological preparations confirmed the safety of the procedure. This indicates that percutaneous brachytherapy for metastatic middle mediastinal lymph nodes can be carried out via the superior vena cava.

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Section: Discussionmentioning

confidence: 97%

Experimental Computed Tomography-guided Vena Cava Puncture in Pigs for Percutaneous Brachytherapy of Middle Mediastinal Lymph Node Metastases

Zhao

Liu

et al. 2015

Chinese Medical Journal

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“…In the last decade there has been a renewed interest in percutaneous brachytherapy for treatment of metastases in mediastinal lymph nodes. The CT‐guided implantation of 125 I seeds in cancer‐containing mediastinal lymph nodes, which combines the advantages of CT intervention and radiotherapy, is popular in China . Li et al .…”

Section: Discussionmentioning

confidence: 99%

¹²⁵Iodine brachytherapy via a trans-superior vena cava approach in patients with metastases in middle mediastinal lymph nodes: a novel approach

Liu

Wang

et al. 2016

Asia-Pac J Clin Oncol

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Aim Certain metastasis‐containing middle mediastinal lymph nodes cannot be approached by standard CT‐guided brachytherapy. We here describe a novel trans‐superior vena cava approach for such nodes. The aim of this prospective study was to assess the safety and clinical value of 125iodine (I) brachytherapy via a trans‐superior vena cava approach in patients with metastases in middle mediastinal lymph nodes. Methods From February 2008 to October 2011, 32 patients with 43 pathologically confirmed metastasis‐containing mediastinal middle lymph nodes underwent CT‐guided percutaneous 125I brachytherapy via a trans‐superior vena cava approach. Their complications and treatment responses were analyzed. Variations in blood pressure, heart rate, hemoglobin concentration and oxyhemoglobin saturation before, during and after the procedure were recorded, as were complications, including hemorrhage, pneumothorax and development of Breuer's reflex. Treatment response was assessed according to the response evaluation criteria for solid tumors Version 1.1. Results According to follow‐up CT examination after 6 months, 22 patients (68.75%) achieved complete responses and four (12. 5%) partial responses. One patient died of myocardial infarction. Overall response rate was 81.25%, with a local control rate of 87.5%. The median survival was 25.7 months, with progression‐free survival of 19.74 ± 0.81 months. The 1‐year and 3‐year overall survival rates were 53.13% and 28.13%. There were minimal immediate or delayed complications; no complications were severe. Conclusion We consider this novel approach a safe means of treating certain mediastinal middle lymph node metastases.

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“…However, treatment of lung metastasis from hepatocellular carcinoma is usually challenging because the previous therapies (including surgery, chemoembolization, radiofrequency ablation, and various combinations of these treatments) limit the options available for subsequent treatment. 125 I brachytherapy has been widely applied for tumor treatment in clinic with significant efficacy providing promising results for local control of solid tumors such as prostate carcinoma, lung cancer, HCC, liver metastasis and pancreatic cancer [3][4][5][6][7][8][9][10]. When permanently implanted into the tumor, 125 I seeds send out continuous low-dose X-ray and γ-ray, leading to a dose of 160 -180 Gy within the local tissue during the half-life of 125 I.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and Safety of CT-Guided <sup>125</sup>I Brachytherapy for Lung Metastasis from Hepatocellular Carcinoma

Yong-xin¹,

Gao²,

Lin³

et al. 2013

OJRad

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To retrospectively evaluate effectiveness and safety of CT-guided 125 I brachytherapy in patients with lung metastasis from hepatocellular carcinoma, sixty lung metastatic lesions in 29 patients were percutaneously treated in 34 125 I brachytherapy sessions. Each metastatic lesion was treated with computed tomographic (CT) guidance. Follow-up contrast material-enhanced CT scans were reviewed and the efficacy of treatment was evaluated. Months are counted from the first time of 125 I brachytherapy and the median duration of follow-up was 11 months (ranging from 6 -17 months). The local control rates after 3, 6, 10 and 15 months were 86.2, 71.4, 60.9 and 50.0% respectively. At the time of writing, ten patients are alive without evidence of recurrence at 11 -15 months. The 10 patients presented good control of local tumor and no systemic recurrence, and survived throughout the follow-up period. Other 11 patients died of multiple hematogenous metastases 5 -15 months after brachytherapy. A small amount of local hematoma occurred in 5 patients that involved applicator insertion through the lung. Four patients presented pneumothorax with pulmonary compression of 30% -40% after the procedure and recovered after drainage. Two patients had minor displacement of radioactive seeds. Severe complications such as massive bleeding and radiation pneumonitis did not occur. So CT-guided 125 I brachytherapy is effective and may be safely applied to lung metastasis from hepatocellular carcinoma.

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Treatment of central type lung cancer by CT guided percutaneous implants of125I radioisotopes

Cited by 6 publications

References 1 publication

Experimental Computed Tomography-guided Vena Cava Puncture in Pigs for Percutaneous Brachytherapy of Middle Mediastinal Lymph Node Metastases

Experimental Computed Tomography-guided Vena Cava Puncture in Pigs for Percutaneous Brachytherapy of Middle Mediastinal Lymph Node Metastases

¹²⁵Iodine brachytherapy via a trans-superior vena cava approach in patients with metastases in middle mediastinal lymph nodes: a novel approach

Effectiveness and Safety of CT-Guided <sup>125</sup>I Brachytherapy for Lung Metastasis from Hepatocellular Carcinoma

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Treatment of central type lung cancer by CT guided percutaneous implants of125I radioisotopes

Cited by 6 publications

References 1 publication

Experimental Computed Tomography-guided Vena Cava Puncture in Pigs for Percutaneous Brachytherapy of Middle Mediastinal Lymph Node Metastases

Experimental Computed Tomography-guided Vena Cava Puncture in Pigs for Percutaneous Brachytherapy of Middle Mediastinal Lymph Node Metastases

125Iodine brachytherapy via a trans-superior vena cava approach in patients with metastases in middle mediastinal lymph nodes: a novel approach

Effectiveness and Safety of CT-Guided &lt;sup&gt;125&lt;/sup&gt;I Brachytherapy for Lung Metastasis from Hepatocellular Carcinoma

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¹²⁵Iodine brachytherapy via a trans-superior vena cava approach in patients with metastases in middle mediastinal lymph nodes: a novel approach

Effectiveness and Safety of CT-Guided <sup>125</sup>I Brachytherapy for Lung Metastasis from Hepatocellular Carcinoma