Efficacy of iodine-125 seed implantation in treating advanced cancer

Objective To evaluate the efficacy of 125I radioactive seeds implantation in treating advanced cancers. Methods Fifteen patients with 24 lesions in total ( 11 primary lesions and 13 metastatic lesions), who stayed in our hospital during June 2006 and November 2008, underwent 125I radioactive seeds implantation under CT guidance. Three patients with carcinoma of ampulla of bile ducts received percutaneous transhepatic cholangiodrainage (PTCD) after biliary stenting, with the 125I seeds input in and along the drainage tube to reach location of tumor obstruction. Extubation was performed three months later.Therapeutic efficacy and complications were observed after implantation. Results Overall response to 125I seed implantation was found in 70.8% (17/24) of the lesions, with complete remission (CR) in 5 lesions (20.8%) and partial remission (PR) in 12 (50.0%). Karnofsky performance status (KPS, median score 70)was higher than that pre-treatment (score 50). Pain relief was achieved in 90% (9/10) of the patients. The overall median survival length was 12.0 months. Pneumothorax, bile leakage and seeds migration were observed in 3 patients. Conclusion 125I radioactive seeds implantation may relieve symptoms and improve quality of life in advanced cancer patients. Key words: Neoplasms; Iodine- 125 seed; Biliary metastasis; Brachytherapy; Percutaneous transhepatic cholangiodrainage