State Key Laboratory of Oncology in South China, Guangzhou 510060, PR China.
Eur J Radiol. 2013 Feb;82(2):e70-5. doi: 10.1016/j.ejrad.2012.09.003. Epub 2012 Oct 3.
To retrospectively evaluate effectiveness and safety of CT-guided (125)I brachytherapy in 16 patients with mediastinal metastatic lymph nodes recurrence from esophageal carcinoma.
Sixteen metastatic lymph nodes in 16 patients were percutaneously treated in 19 (125)I brachytherapy sessions. Each metastatic lymph node was treated with computed tomographic (CT) guidance. Follow-up contrast material-enhanced CT or positron emission tomographic (PET) scans were reviewed and the treatment's effectiveness was evaluated.
Months are counted from the first time of (125)I brachytherapy and the median duration of follow-up was 11 months (range, 5-16 months). The local control rates after 3, 6, 10 and 15 months were 75.0, 50.0, 42.9 and 33.3% respectively. At the time of writing, four patients are alive without evidence of recurrence at 16, 9, 16 and 9 months. The 4 patients presented good control of local tumor and no systemic recurrence, and survived throughout the follow-up period. The other 12 patients died of multiple hematogenous metastases 5-15 months after brachytherapy. A small amount of local hematoma occurred in 2 patients that involved applicator insertion through the lung. Two patients presented pneumothorax with pulmonary compression of 30 and 40% after the procedure and recovered after drainage. One patient had minor displacement of radioactive seeds. Severe complications such as massive bleeding and radiation pneumonitis did not occur.
(125)I radioactive seed implantation is effective and may be safely applied to mediastinal metastatic lymph nodes recurrence from esophageal carcinoma.
回顾性评估 CT 引导下（125）I 放射性粒子近距离治疗 16 例食管癌纵隔转移淋巴结复发患者的有效性和安全性。
16 例患者的 16 个转移淋巴结共进行了 19 次（125）I 放射性粒子近距离治疗。每个转移淋巴结均采用 CT 引导进行治疗。通过对比增强 CT 或正电子发射断层扫描（PET）进行随访，评估治疗效果。
从首次（125）I 放射性粒子近距离治疗开始计算，中位随访时间为 11 个月（5-16 个月）。3、6、10 和 15 个月后的局部控制率分别为 75.0%、50.0%、42.9%和 33.3%。截至撰写本文时，4 例患者分别在 16、9、16 和 9 个月时无肿瘤复发且存活，这 4 例患者局部肿瘤得到了很好的控制，无全身复发，在整个随访期间存活。其余 12 例患者在放射性粒子近距离治疗后 5-15 个月死于多发血行转移。2 例患者通过经肺穿刺器插入时有少量局部血肿，2 例患者在术后出现气胸，肺压缩分别为 30%和 40%，引流后恢复。1 例患者有放射性粒子轻微移位。未发生严重并发症，如大出血和放射性肺炎。
（125）I 放射性粒子植入术对于食管癌纵隔转移淋巴结复发是有效且安全的。
