Role of brachytherapy in the management of pulmonary and mediastinal malignancies

2015

Oncology Letters

Abstract. The aim of the present study was to investigate the efficacy and safety of combined therapy with iodine-125 seed implantation and the gemcitabine plus cisplatin chemotherapeutic regimen, as well as treatment with the radiosensitizer sodium glycididazole (CMNa), in patients with non-small cell lung cancer (NSCLC). The 40 patients with NSCLC in the experimental group (19 females; mean age, 52.3±11.5 years; age range, 34-74 years) received the combined therapy and CMNa, and the 41 controls (13 females; mean age, 53.7±10.7 years; age range, 8-79 years) received the combined therapy only. The response rate in the experimental group was significantly higher than in the control group (85.5 vs. 63.4%; P=0.027), with no apparent complications. Therefore, it was concluded that such therapy may be reliable and well-tolerated for the treatment of patients with NSCLC.

mentioning

confidence: 70%

Sodium glycididazole enhances the efficacy of combined iodine-125 seed implantation and chemotherapy in patients with non small-cell lung cancer

Zhang

2015

Oncology Letters

“…Interstitial permanent brachytherapy, first described by Paterson and Parker in 1934, has been mostly used for head and neck, lung, pancreatic, and prostatic malignancies [25][26][27][28]. It is based on the implantation of radioactive sources inside or close to the tumor target, delivering a high dose of radiation directly to the tumor while sparing surrounding normal tissues due to a sharp dose drop-off outside the implanted target area.…”

Section: Discussionmentioning

confidence: 99%

“…Using the half-values in tissue of the 125 I and 103 Pd seeds of 1.7 cm and 1.6 cm, respectively, the distance between adjacent seeds was adjusted to ensure that overlapping c-ray radiation covered the tumor target but not the adjacent normal tissue. With increase in distance from the radioactive seeds, the radiation dose decreases rapidly [26]. Therefore, unlike EBRT, the seed implants should not lead to serious complications.…”

Section: Discussionmentioning

confidence: 99%

CT-guided radioactive seed implantation for recurrent rectal carcinoma after multiple therapy

Yuan

et al. 2009

Med Oncol

The recurrent carcinoma has been difficult to manage after surgery and radiotherapy, extensive resection of locally recurrent rectal cancer is associated with significant morbidity and mortality. Re-irradiation, even in combination with chemotherapy has shown very short survival. We assess the feasibility and efficacy of CT-guided interstitial permanent brachytherapy with (125)I or (103)Pd seeds for recurrent rectal cancer after multiple treatments. Fifteen patients with locally recurrent rectal carcinoma received (125)I or (103)Pd seed implants under CT guidance. The minimal peripheral dose of seed implants was 110-165 Gy (median 150 Gy). Two weeks after seed implantation, a 50 Gy of stereotactic radiotherapy was given to one patient; four patients received 2-4 cycles of chemotherapy. A median follow-up was 8 months (range 4-50 months). The duration of pain-free survival was 0-50 months (median 7 months). Local control was maintained for 3-50 months (median 7 months). The 1- and 2-year local controls were 16.2 and 8.1%, respectively. Eleven patients died: two (18.2%) of local recurrence, seven (63.6%) of local recurrence and metastases, and two (18.2%) of metastases. Four patients (26.7%) survived the median survival was 9 months. The 1- and 2-year actuarial overall survival rates were 42.9% and 10.7%, respectively. One patient (7.6%) experienced a grade 4 toxic event; there was no associated neuropathy. CT-guided radioactive seed implantation is feasible and safe as a salvage or palliative pain relief treatment for patients with recurrent rectal cancers after surgery and radiotherapy.

“…The beneficial characteristics of 125 I seed implants are safety, low energy, sustaining accumulated radiation, and homogenous dose distribution in the target area. Recently, 125 I seed implants have been mainly applied to treat head and neck carcinoma, lung cancer, pancreatic carcinoma, and prostate carcinoma [10][11][12][13]. The radiobiological advantages of interstitial 125 I seed implants include: (1) reduced treatment time; (2) high radiation dose at the tumor; (3) more effective delivery of radiation; and (4) relative sparing of overlying spine [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Interstitial 125I seeds implantation to treat spinal metastatic and primary paraspinal malignancies

Yuan

et al. 2009

Med Oncol

Spinal cord metastatic malignancies and locally invasive paraspinal carcinomas were severe pain and disabling complications. The treatment modality was unclear. We retrospectively evaluated the safety and efficacy of (125)I seed implantation for spinal metastatic and paraspinal malignancies in our center. A total of 19 patients and 22 procedures were included in this study. Eight patients received a seed implant in an operation, and 11 patients were implanted percutaneously under CT-guidance. The number of (125)I seeds implanted ranged from 6 to 100, with a median of 26. The specific activity of (125)I seeds ranged from 0.45 to 0.80 mCi per seed, with a median of 0.5 mCi. The minimal peripheral doses of (125)I seed implantation were 90-140 Gy, with median of 120 Gy. Follow-up ranged from 3 to 69 months with a median of 22 months. All patients tolerated seed implantation well. The 1, 2, 3, and 5 year local control rates were 63%, 47%, 31%, and 3%, respectively, with a median of 22 months (3-61 months). The 1, 2, 3, and 5 year survival rates were 74%, 56%, 43%, and 43%, respectively, with a median of 33 months. Ten patients (52.6%) developed distant metastases. Two (10.5%) patients showed recurrence at 13 and 39 months. Seven (36.8%) patients were still alive, 84% (16/19) of patients had either normal or improved ambulation following seed implant. No myelopathies were encountered. Our study suggests a promising local therapy for a selected population of patients with spinal cord metastatic or paraspinal carcinoma.