Efficacy of Permanent Iodine-125 Seed Implants and Gemcitabine Chemotherapy in Patients with Platinum-Resistant Recurrent Ovarian Carcinoma

Abstract

Background: The aim of this study was to explore the efficacy and adverse reactions of CT-guided radioactive 125I-seed implantation treatment combined with chemotherapy for platinum-resistant recurrent ovarian carcinoma. Materials and Methods: From September 2010 to December 2012, 23 patients with platinum-resistant recurrent ovarian carcinoma were enrolled. All the patients refused, could not bear, or were not suitable for surgery. They all had no more than 3 lesions, which were detected and could also be measured by CT. All were clarified as single-lesion or multiple-lesion groups. A total of 41 lesions underwent implantation of from 8 to 106 125I seeds (median=43). Multi-plane implanting was adopted and 125I-seeds of (0.4-0.7)mCi were placed at intervals of (0.5-1.0) cm. After implantation treatment, all patients underwent 4 cycles of chemotherapy with gemcitabine 800 mg/m2 (days 1, 8 and 15). Results: The outcome was evaluated with CT 3 weeks and every 3 months after implantation treatment. After 6 months, the volume of 32 out of 41 lesions (78.0%) was reduced at least 30%, within which 9 lesions completely disappeared(22.0%). Complete response was observed in 7 cases (30.4%), with a partial response in 4 cases (17.4%),4 cases stable(17.4%)and 8 cases showing progression (34.8%). The total clinical remission rate was 47.8% (11/23). The clinical remission rate was 77.8% (7/9) in the single-lesion group and 28.6% (4/14) in the multiple-lesion group with a significant difference between the two(P=0.036). The common side effects observed were mild gastrointestinal reactions. Conclusions: 125I-seed implantation combined with chemotherapy applies an effective way in the treatment of platinum-resistant recurrent ovarian epithelial carcinoma with the advantages of high local control rates, good short-term effects, little trauma and less side effects.

Permanent Iodine-125 Seed Implantation for the Treatment of Nonresectable Retroperitoneal Malignant Tumors

“…Radioactive 125 I seed implantation has been used to treat malignant tumors and achieved significant clinical effect. [8][9][10] This brachytherapy has been shown to be effective in controlling local progress of malignant carcinoma for those patients who have no opportunity for surgical treatment. In the current study, a total of 26 patients with nonresectable retroperitoneal malignant tumors were treated with radioactive 125 I seed implantation under the guidance of ultrasonic examination.…”

WITHDRAWN: Image-guided navigation systems for interstitial brachytherapy

“…In the past 20 years, interstitial brachytherapy has shown quite promising therapeutic effects in the treatment of tumors in various body regions. When tumors are unresectable, recurrent, with positive surgical margins or located nearby risk structures, interstitial brachytherapy can be used as a complementary therapy for surgery, chemotherapy, external beam radiotherapy and interventional techniques such as RFA (Radiofrequency Ablation), MWA (Microwave Ablation) and TACE (Transhepatic Arterial Chemotherapy Embolization) [1][2][3][4][5]. The most widely used form of interstitial brachytherapy is probably the transrectal ultrasound (US)-guided prostate brachytherapy [6,7].…”

Modified Fan-Shaped Distribution Technology for Computed Tomography (CT)-Guided Radioactive Seed Implantation in Lung Cancer Patients with Lung Dysfunction

“…Radioactive 125I seed interstitial implantation is a brachytherapy technology featuring a small radiation radius. After implantation, the tumor itself has a high therapeutic dose, and surrounding normal tissues receives less radiation, so it has been widely used in treatment of various solid tumors [ 5 – 12 ]. Furthermore, this technology has high conformality because seeds are implanted on the basis of tumor shape, which was first applied in prostate cancer therapy and achieved great effects.…”