CT-guided 125I seed implantation for locoregional lymph node metastases in patients with recurrent gastric cancer

Objective To evaluate the safety and short term effect of 125I seed implantation for locoregional lymph node metastases in patients with recurrent gastric cancer.Methods The data of 23 gastric cancer patients with locoregional lymph node metastases treated by CT-guided 125I seed implantation were retrospectively studied.Patient characteristics and survival data were collected and analyzed.The procedure for seed implantation was performed under CT guidance according to preoperative treatment planning.Evaluation of short-term effect was carried out two months after the 125I seed implantation using response evaluation criteria in solid tumors (RECIST).The 1-,2-and 3-year survival rates were plotted using the life table method.The potential predictors of survival were tested using univariate Cox models.Log-rank method was used to test the difference of survival in subgroups with tumor size ＞3 cm and ＜3 cm.Twenty patients underwent fluoropyrimidine-based chemotherapy after 125I seed implantation.Results None of the 23 patients had serious complications.Two months after 125I seed implantation,the CR,PR and PD rates were 60.9％ (14/23),21.7％ (5/23) and 17.4％ (4/23),respectively.The median survival time was (22.1±5.1) months,and the 1-,2-,3-year survival rates were (87±7) ％,(47± 11) ％ and (13 ±9) ％,respectively.The tumor size (longest diameter) was the most significant factor for prognosis (x2=9.752,P=0.002).Patients with tumor ＜3 cm in diameter had longer survival time than those with tumor ＞3 cm ((30.0±5.1) vs (17.0±5.0) months;x2 =5.828,P=0.016).Conclusion CT-guided brachytherapy using 125I seed implantation is a safe and effective method for palliative treatment of locoregional lymph node metastases for recurrent gastric cancer. Key words: Stomach neoplasms ;  Lymphatic metastasis ;  Brachytherapy ;  Iodine radioisotopes ; Tomography, X-ray computed