Department of Medical Imaging & Interventional Radiology, Cancer Center and State Key Laboratory of Oncology in South China, Sun Yat-sen University, Guangzhou, People's Republic of China.
Melanoma Res. 2014 Apr;24(2):137-43. doi: 10.1097/CMR.0000000000000028.
The aim of this study is to evaluate the therapeutic efficacy of computed tomography (CT)-guided interstitial iodine-125 (I) seed implantation for metastatic malignant melanoma treatment. From November 2008 to May 2011, 24 patients with metastatic malignant melanoma who had undergone surgery for excision of primary lesions and repeated chemotherapy underwent CT-guided I seed implantation. Their clinical situations, biochemical indicators, MRIs, and CTs were observed. The follow-up time ranged from 5 to 24 months (mean 19.6 months). The local control rates of metastatic malignant melanoma after surgery excision for primary lesion after 2, 6, 12, and 24 months were 86.8, 78.6, 62.1, and 55.0%, respectively. One patient died of liver failure 5 months after brachytherapy and another died of a metastatic brain tumor 8 months after brachytherapy. Two patients died of lung dysfunction from pulmonary metastases 15 months after brachytherapy. All other patients survived throughout the follow-up period. The 2-year survival rate was 83.3%. During the procedure, one patient presented with minimal bleeding from the applicator route and another presented with pneumothorax with 20% pulmonary compression, which improved after intraprocedure suctioning. Four patients had low-grade fever on day 3. Three showed mild decreases in their white blood cell counts. CT-guided I seed implantation is a safe, feasible, and promising approach to the treatment of patients with metastatic malignant melanoma after surgery excision for primary lesions and repeated chemotherapy, but large-scale randomized clinical trials should be conducted before the technique can be used routinely.
本研究旨在评估 CT 引导下碘-125（I）粒子间质植入治疗转移性恶性黑色素瘤的疗效。2008 年 11 月至 2011 年 5 月，24 例接受过原发灶切除和反复化疗的转移性恶性黑色素瘤患者接受了 CT 引导下 I 粒子植入术。观察了他们的临床情况、生化指标、MRI 和 CT。随访时间为 5 至 24 个月（平均 19.6 个月）。术后切除原发灶后，转移性恶性黑色素瘤的局部控制率分别为 2 个月、6 个月、12 个月和 24 个月时的 86.8%、78.6%、62.1%和 55.0%。1 例患者在近距离放疗后 5 个月因肝功能衰竭死亡，1 例患者在近距离放疗后 8 个月因脑转移瘤死亡。2 例患者在近距离放疗后 15 个月因肺转移引起的肺功能障碍死亡。所有其他患者在整个随访期间均存活。2 年生存率为 83.3%。在该过程中，1 例患者在施源器途径出现少量出血，另 1 例患者出现气胸，肺压缩 20%，经术中抽吸后改善。4 例患者在第 3 天出现低热，3 例患者出现白细胞计数轻度下降。CT 引导下 I 粒子植入术是一种安全、可行且有前途的治疗方法，适用于接受过原发灶切除和反复化疗的转移性恶性黑色素瘤患者，但在该技术常规应用之前，应进行大规模随机临床试验。
