Objectives: To evaluate the feasibility and clinical value of CT-guided
iodine-125 (125I)
brachytherapy for
pain palliation in patients with
breast cancer and bone
metastases after external beam
radiotherapy failure. Methods: From January 2014 to July 2016, a total of 90 patients, who had received the standard
therapies for bone
metastases but still suffered moderate-to-severe
pain, were retrospectively studied. About 42 patients were treated with both 125I
brachytherapy and
bisphosphonates (Group A), and 48 patients were treated with
bisphosphonates alone (Group B). Results: In Group A, 45 125I
brachytherapy procedures were performed in 42 patients with 69 bone
metastases; the primary success rate of 125I seed implantation was 92.9%, without severe complications. Regarding
pain progression of the two groups, Group A exhibited significant relief in "worst
pain," "least
pain," "average
pain," and "present
pain" 3-day
after treatment and could achieve a 12-week-remission for "worst
pain," "least
pain," "average
pain," and "present
pain." The
morphine-equivalent 24-h
analgesic dose at 3 days, 4 weeks, 8 weeks, and 12 weeks was 91 ± 27, 53 ± 13, 31 ± 17, and 34 ± 12 mg for Group A, and 129 ± 21, 61 ± 16, 53 ± 15, and 105 ± 23 mg for Group B. Group A experienced a lower incidence of
analgesic-related adverse events and better quality of life than Group B. Conclusion: The CT-guided 125I
brachytherapy is a feasible and an effective treatment for the palliation of
pain caused by bone
metastases from
breast cancer after external beam
radiotherapy failure.