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

Abstract

BackgroundThe aim of this study was to investigate the safety and effectiveness of fan-shaped distribution and coaxial puncture technology for radioactive iodine 125 (125I) seed implantation in treatment of lung cancer patients with lung dysfunction.Material/MethodsWe enrolled and analyzed 33 lung cancer patients with lung dysfunction diagnosed in our hospital from 2013 to 2014 in this study, all of which were implanted with radioactive 125I seed with technology of fan-shaped distribution and coaxial puncture. The matched peripheral dose (MPD) range was 90–140GY. The brachytherapy planning system (TPS) was used to draw up a preoperative seed implantation plan. The fan-shaped distribution system was applied to simulate a surgery program, and seed implantation pitch was 0.5–1.0 cm. Real-time adjustment was necessary during surgery. Dose distributions were verified by TPS immediately after implantation. Intraoperative and postoperative surgery-related complications were analyzed. All patients were followed up for 6 months, and the local control rate of cancer was evaluated through CT scan.ResultsAll patients were operated on successfully. The main surgery-related complications were pulmonary hemorrhage, pleural cavity hemorrhage, and pneumothorax. The local control rates of 2-month, 4-month, and 6-month were 29%, 73%, and 85%, respectively. The total complete remission rate was 18%, the partial response rate was 67%, the stable disease rate was 12%, and the disease progression rate was 3%.ConclusionsThe fan-shaped distribution and coaxial puncture technology for radioactive 125I seed implantation was safe and effective in treating lung cancer patients with lung dysfunction.

125I seed implantation for lymph node metastasis from radioactive iodine-refractory differentiated thyroid carcinoma: a study on short-term efficacy and dosimetry

“…However, in this study, the HI before and after the procedure is low, and the postoperative verification V 150 exceeds 50%, suggesting an uneven dose distribution in the target area and an excessive volume of high-dose region. The possible causes of the errors were analyzed: (1) The change in focus size and the rapid reduction of perifocal edema accelerated the dispersion and regression of radiation dose, resulting in a decrease in the conformal index of dose distribution within the focus ( 21 – 27 ). Additionally, the postoperative verification dose does not reflect the actual absorbed dose of the tumor.…”

125I seeds implantation for lymph nodes metastasisfrom radioactive iodine-refractory differentiated thyroid carcinoma: A short-term efficacy and dosimetry study

“…However, in this study, the HI before and after operation is low, and the postoperative veri cation V150 is more than 50%, indicating that the dose distribution in the target area is uneven, and the volume of the high dose area is too large. The possible causes of the errors were analyzed: (1) the change of focus size and the rapid reduction of perifocal edema accelerated the dispersion and regression of radiation dose and reduced the conformal index of dose distribution within the focus [14][15][16][17][18][19]. And the postoperative veri cation dose is not the actual absorbed dose of the tumor, in this study, the postoperative veri cation time is within 24 hours, and the local unsubsided tissue edema within a short time after operation will affect the evaluation of biological effect dose [18].…”

25I seeds implantation for lymph nodes metastasisfrom radioactive iodine-refractory differentiated thyroid carcinoma: A short-term efficacy and dosimetry study

“…However, the HI before and after the operation in this study was low, and the postoperative veri cation V150 was more than 50%, suggesting that the dose distribution in the target area is uneven and the volume of the high-dose area is too large. Analyze the possible reasons for the error: (1) Postoperative changes in the size of the lesion and rapid reduction of edema around the lesion accelerate the dispersion and regression of radiation doseand reduce the conformation index of the dose distribution within the lesion [14][15][16][17][18][19]; and The veri cation dose is not the actual absorbed dose of the tumor. In this study, the postoperative veri cation time was within 24 hours.…”