Feasibility and clinical value of CT-guided 125I brachytherapy for metastatic soft tissue sarcoma after first-line chemotherapy failure

Mo, Zhiqiang; Zhang, Tao; Zhang, Yanling; Xiang, Zhanwang; Yan, Huzhen; Zhong, Zhihui; Gao, Fei; Zhang, Fujun

doi:10.1007/s00330-017-5036-0

Cited by 30 publications

(24 citation statements)

References 25 publications

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“…Previous studies have shown that the maximum diameter is an independent factor affecting the LTPFS of 125 I brachytherapy [21]. The same conclusion was obtained in this study.…”

Section: Discussionsupporting

confidence: 92%

“…One of the main advantages of 125 I brachytherapy is the high local control [16,21,[35][36][37]. Therefore, we used LTPFS as the primary end point, and used Kaplan-Meier analysis and log-rank test to explore the factors affecting LTPFS.…”

Section: Discussionmentioning

confidence: 99%

“…The dose within PTV should achieve 95% of the prescribed dose (Vl00 > 95%). According to our previous research experience, the prescription dose was 120 (110-140) Gy [15,19,21]. Fused lymph nodes means multiple lymph nodes (2-5) merge into one large lymph node.…”

Section: Brachytherapymentioning

confidence: 99%

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Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

et al. 2020

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Background: Due to the unique anatomical location of retroperitoneal metastatic lymph nodes, current treatment options are limited. This study was designed to explore the clinical efficacy and prognostic factors of CT-guided 125 I brachytherapy for the treatment of retroperitoneal metastatic lymph nodes. Methods:We retrospectively evaluated 92 patients received 125 I brachytherapy for retroperitoneal metastatic lymph nodes. A layered Cox proportional hazards model was established to filter out the independent factors affecting local tumor progression-free survival (LTPFS).Results: The median LTPFS was 8 months. Metastatic lymph node with uniform density (p-0.009), clear boundaries (p-0.011), regular morphology (P < 0.001), and < 3 organs at risk of metastasis (p-0.020) were associated with better LTPFS. Necrotic lymph nodes (p < 0.001), fusion (p-0.003), and invasion of vessels visible on images (p < 0.001) were associated with poor LTPFS. Puncture path through abdominal wall or paravertebral approach were also associated with better LTPFS than a hepatic approach (P < 0.05). A maximum diameter ≤ 3 cm (P-0.031) or 3-5 cm (P-0.018) were also associated with significantly better LTPFS than a maximum diameter ≥ 5 cm. The Cox proportional hazards model suggested that lymph nodes invaded the large vessels visible on images, maximum diameter and puncture path were independent risk factors for LTPFS.Conclusion: CT-guided 125 I brachytherapy is an optional palliative treatment modality for retroperitoneal metastatic lymph nodes, which can provide high local control without severe complications. Better preoperative planning, intraoperative implementation, better choice of puncture path, and selection of appropriate tumor size are important factors that can improve the clinical efficacy of 125 I brachytherapy for retroperitoneal metastatic lymph nodes.

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“…Previous studies have shown that the maximum diameter is an independent factor affecting the LTPFS of 125 I brachytherapy [21]. The same conclusion was obtained in this study.…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

et al. 2020

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“…In order to expand the indications of RSI-BT, CT-guidance technique was integrated into RSI-BT in 2002 in China, which was used to treat head and neck, thoracic, abdomen, and spinal vertebrate carcinoma [25][26][27][28][29][30]. The CTguided 125I RSI-BT was very safety and effective approach for anti-cancer treatment, especially for recurrent or metastasis carcinomas.…”

Section: Discussionmentioning

confidence: 99%

The accuracy and safety of CT-guided iodine-125 seeds implantation assisted by 3D non-coplanar template for retroperitoneal recurrent carcinoma.

Wang

Jiang

Wei

et al. 2020

Preprint

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Purpose To investigate the accuracy, dosimetric parameters and safety of 3D-printing non co-planar template (3D-PNCT) assisted CT-guidance for radioactive iodine-125 (125I) seed implantation brachytherapy (RSI-BT) for retroperitoneal recurrent carcinomas. Methods and materials: We enrolled 15 patients with 17 retroperitoneal recurrent carcinomas after external beam radiotherapy (EBRT). All patients received CT-guided 125I RSI-BT assisted by 3D-PNCT successfully. We compared the original needles insertion position, angular and the needle tips distance deviations of preoperative plan with that of intra-operative in brachytherapy treatment-planning system (B-TPS). The dosimetric parameters of RSI-BT were evaluated on preoperative plan, intra-operative real-time plan and postoperative plan, including D90, D100, V100, V150 and V200. The quality assurance of RSI-BT evaluated on conformal index (CI), external index (EI), homogeneity index (HI) of the targets were compared among preoperative plan, intra-operative real-time plan and postoperative plan. The peri-operation complications and re-radiation related toxicity were assessed. Results The median follow-up was 8.2 months (range 1-18.5months). One patient lost follow-up after RSI-BT. 14 patients were assessed for response rate and toxicity. The mean entrance point distance deviation for all 165 needles was 4.50 ± 4.10 mm (range, 0–30). The mean angular deviation was 2.70 ± 3.00 degrees (range, 0–20). The needles tip distances deviation was 6.90 ± 6.00 mm (range, -30-28). D90 for preoperative plan, intra-operative plan and postoperative plan were 140.55 ± 23.93, 124.25 ± 28.04,128.98 ± 22.75. There was significant difference between D90 of preoperative plan with that of intraoperative plan (p = 0.036). Four patients reached CR, three patients reached PR, three patients were SD and three patients was PD. Four patients with middle pain became moderate, two with moderate pain relived completely after RSI-BT. The others parameters showed no differences among preoperative plan, intraoperative plan and postoperative plan. The perioperative complications were observed in four patients, including three patients of grade 1 and one patient of grade 2. No ≥ grade 3 side-effects were observed. Conclusion CT-guided 125I RSI-BT assisted by 3D-PNCT was a safe, accurate and feasible strategy for recurrent carcinomas located in retroperitoneal regions.

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“…In order to expand the indications of RSI-BT, CT-guidance technique was integrated into RSI-BT in 2002 in China, which was used to treat head and neck, thoracic, abdomen, and spinal vertebrate carcinoma [25][26][27][28][29][30]. The CT-guided 125I RSI-BT was very safety and effective approach for anti-cancer treatment, especially for recurrent or metastasis carcinomas.…”

Section: Discussionmentioning

confidence: 99%

The accuracy and safety of CT-guided iodine-125 seeds implantation assisted by 3D non-coplanar template for retroperitoneal recurrent carcinoma.

Wang

Jiang

Wei

et al. 2020

Preprint

View full text Add to dashboard Cite

Purpose: To investigate the accuracy, dosimetric parameters and safety of 3D-printing non co-planar template (3D-PNCT) assisted CT-guidance for radioactive iodine-125 (125I) seed implantation brachytherapy (RSI-BT) for retroperitoneal recurrent carcinomas.Methods and materials: We enrolled 15 patients with 17 retroperitoneal recurrent carcinomas after external beam radiotherapy (EBRT). All patients received CT-guided 125I RSI-BT assisted by 3D-PNCT successfully. We compared the original needles insertion position, angular and the needle tips distance deviations of preoperative plan with that of intra-operative in brachytherapy treatment-planning system (B-TPS). The dosimetric parameters of RSI-BT were evaluated on preoperative plan, intra-operative real-time plan and postoperative plan, including D90, D100 (the dose to 90% and 100% of the target volume), V100, V150 and V200 (the volume receives 100%, 150% and 200% of the prescribed doses). The quality assurance of RSI-BT evaluated on conformal index (CI), external index (EI), homogeneity index (HI) of the targets were compared among preoperative plan, intra-operative real-time plan and postoperative plan. The peri-operation complications and RSI-BT related toxicity were assessed.Results: The median follow-up was 8.2 months (range 1-18.5months). One patient lost follow-up after RSI-BT. 14 patients were assessed for response rate and toxicity. The mean entrance point distance deviation for all 165 needles was 4.50 ± 4.10 mm (range, 0-30). The mean angular deviation was 2.70 ± 3.00 degrees (range, 0-20). The needles tip distances deviation was 6.90 ± 6.00 mm (range, -30-28). D90 for preoperative plan, intra-operative plan and postoperative plan were 140.55 ± 23.93, 124.25 ± 28.04,128.98 ± 22.75. There was significant difference between D90 of preoperative plan with that of intraoperative plan (p=0.036). Four lesions reached CR, six lesions reached PR, three lesions were SD and three lesions was PD. Four patients with moderate pain became mild, two with mild pain relived completely after RSI-BT. The others parameters showed no differences among preoperative plan, intraoperative plan and postoperative plan. The perioperative complications were observed in four patients, including three patients of grade 1 and one patient of grade 2. No ≥ grade 3 side-effects were observed.Conclusion: CT-guided 125I RSI-BT assisted by 3D-PNCT was a safe, accurate and feasible strategy for recurrent carcinomas located in retroperitoneal regions.

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Feasibility and clinical value of CT-guided 125I brachytherapy for metastatic soft tissue sarcoma after first-line chemotherapy failure

Abstract: • I brachytherapy is feasible and valuable for treating metastatic soft tissue sarcoma. • I brachytherapy represents a prominent activity in disease control. • I brachytherapy can achieve better symptom relief and quality of life.

Cited by 30 publications

References 25 publications

Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

The accuracy and safety of CT-guided iodine-125 seeds implantation assisted by 3D non-coplanar template for retroperitoneal recurrent carcinoma.

The accuracy and safety of CT-guided iodine-125 seeds implantation assisted by 3D non-coplanar template for retroperitoneal recurrent carcinoma.

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