Wang Jun Jie, Yuan Hui Shu, Li Jin Na, Jiang Wei Juan, Jiang Yu Liang, Tian Su Qing
Department of Radiation Oncology, Peking University Third Hospital, Beijing, China.
Int J Colorectal Dis. 2009 Apr;24(4):391-9. doi: 10.1007/s00384-008-0628-4. Epub 2008 Dec 16.
To assess the feasibility, efficacy, and morbidity of (125)I seeds interstitial permanent implant as salvage therapy for re-recurrent rectal cancer.
From September 2003 to October 2007, (125)I seeds implant procedures were performed under CT or ultrasound guidance for thirteen patients with locally re-recurrent rectal carcinoma. The minimal peripheral doses (MPD) of (125)I seeds implanted ranged from 120 to 160 Gy, with a median MPD of 140 Gy to total decay. Three patients also received two to four cycles of chemotherapy after seed implantation.
After a median follow-up of 10 months (range 3-45), the pain-free interval was 0-14 months with a median of 7 months (95% CI: 3-11 months). The response rate of pain relief was 46.2% (6/13). Local control was 3-14 months with a median of 7 months (95% CI: 3.5-10.5 months). The 1- and 2-year local control rates were 14.4% and 0%, respectively. Three (23.1%) patients died of local recurrence; seven (53.8%) patients died of local recurrence and metastases; one (7.7%) patient died of metastases. Two (15.4%) patients survived to follow-up. At the time of analysis, the median survival was 10 months (95% CI: 3.9-16.1 months). The 1- and 2-year actuarial overall survival rates were 46.2% and 11.5%, respectively. Two (15.4%) patients experienced a grade 4 toxic event. Seed migration to the pelvic wall was observed in one (7.7%) patient. There was no associated neuropathy.
(125)I seed implantation is feasible, effective, and safe as a salvage or palliative treatment for patients with re-recurrent rectal cancer.
评估¹²⁵I粒子组织间永久植入作为复发性直肠癌挽救性治疗的可行性、疗效及并发症。
2003年9月至2007年10月，对13例局部复发性直肠癌患者在CT或超声引导下进行¹²⁵I粒子植入手术。¹²⁵I粒子植入的最小周边剂量（MPD）为120至160Gy，总衰变时MPD中位数为140Gy。3例患者在粒子植入后还接受了2至4个周期的化疗。
中位随访10个月（范围3至45个月），无痛间期为0至14个月，中位数为7个月（95%CI：3至11个月）。疼痛缓解有效率为46.2%（6/13）。局部控制时间为3至14个月，中位数为7个月（95%CI：3.5至10.5个月）。1年和2年局部控制率分别为14.4%和0%。3例（23.1%）患者死于局部复发；7例（53.8%）患者死于局部复发和转移；1例（7.7%）患者死于转移。2例（15.4%）患者存活至随访。分析时，中位生存期为10个月（95%CI：3.9至16.1个月）。1年和2年总生存率分别为46.2%和11.5%。2例（15.4%）患者发生4级毒性事件。1例（7.7%）患者观察到粒子迁移至盆腔壁。未出现相关神经病变。
¹²⁵I粒子植入作为复发性直肠癌患者的挽救性或姑息性治疗是可行、有效且安全的。
