Radiofrequency ablation versus 125I-seed brachytherapy for painful metastases involving the bone

Abstract

This retrospective study aimed to demonstrate and compare the safety and effectiveness of computed tomography-guided radiofrequency ablation (RFA) and 125I-seed brachytherapy for painful bone metastases after failure of external beam radiotherapy (EBRT). From June 2013 to October 2015, 79 patients with moderate-to-severe pain caused by metastatic bone lesions who underwent either RFA (n = 41) or 125I-seed brachytherapy (n = 38) were enrolled. Pain in patients was measured using the brief pain inventory (BPI) before treatment, 1 week after treatment, and 3 months after treatment. Response rates were assessed by measuring the changes in pain and incorporation of changes in the analgesic requirements. At baseline, 1 week, and 3 months, the mean worst pain scores of BPI were 7.8, 5.4, and 2.7, respectively, for the RFA group and 7.7, 6.1, and 2.8, respectively, for the brachytherapy group. At 1 week, the complete and partial response rates were 12% and 59%, respectively, in the RFA group compared with 3% and 45%, respectively, in the brachytherapy group. At 3 months, the complete and partial response rates were 23% and 58%, respectively, in the RFA group compared with 24% and 52% in the brachytherapy group (p = 0.95). The response rates in the RFA group were significantly higher than those in the brachytherapy group at 1 week (p = 0.32), but comparable at 3 weeks (p = 0.95). Both groups had low rates of complications and no treatment-related mortality. In conclusion, the short-term curative efficiency of RFA was better than that of brachytherapy, but the log-term efficiency of both treatments was equal.

¹²⁵I seed brachytherapy versus external beam radiation therapy for the palliation of painful bone metastases of lung cancer after one cycle of chemotherapy progression

“…The proportion of patients according to the severity of pain was also significantly different between Groups A and B at T 2 ( P <0.01), T 4 ( P <0.01), T 6 ( P <0.01), T 8 ( P <0.01), T 20 ( P <0.01), and T 24 ( P <0.01). These results are consistent with those of previous studies on 125 I brachytherapy for the management of painful bone metastases secondary to lung or liver cancer 21. A potential reason for the successful pain palliation achieved with 125 I brachytherapy might be the radiation dose.…”

Efficacy and safety of iodine-125 brachytherapy combined with chemotherapy in the treatment of advanced NSCLC in the elderly

“…Thus, iodine-125 seeds can be used as a safe and effective method for patients who develop painful bone metastases. 36 In our research, there was no severe complications, such as massive hemoptysis, radiation pneumonitis, severe pneumothorax, infection, hematological toxicity, liver or kidney function lesion, or death ( Tables 5 and 6 ). Patients treated in group A were clearly better than those in group B regarding many aspects, such as health status/QOL, physical functioning, fatigue, and pain relief.…”

Interventional Oncology: Should Interventional Radiotherapy (Brachytherapy) be Integrated into Modern Treatment Procedures?

“…[9,[31][32][33] Treatments with favorable outcome were reported in different anatomic sites like head & neck-, bone-, liver-, soft tissue-and peripheral lung tumors or oligometastes. [9,[34][35][36][37][38][39][40] Recently, the advantage of a robotic implantation with the use of a personalized 3D printed template compared to the manual implantation with personalized 3D printed template guidance was documented. [41] Some groups use seed implants, other the HDR stepping source technology.…”