CT-guided permanent 125I seed interstitial brachytherapy for recurrent retroperitoneal lymph node metastases after external beam radiotherapy.

Abstract

PURPOSE:

To evaluate the feasibility, efficacy, and safety of permanent (125)I seed interstitial brachytherapy reirradiation in patients with retroperitoneal lymph node recurrence under CT guidance.

METHODS AND MATERIALS:

Seventeen patients with 19 retroperitoneal lymph node recurrence after external beam radiotherapy underwent CT-guided (125)I seed implant brachytherapy from October 2007 to August 2014. Treatment for all patients was preplanned using a three-dimensional radiation therapy planning system 3-5 days before brachytherapy; dosimetry verification was performed immediately after brachytherapy.

RESULTS:

The actuarial D90 (dose delivered to 90% of the target volume) was 100-198 Gy (median, 126.5 Gy). In 9 patients, pain intensity decreased to mild pain 1-3 weeks after brachytherapy. Pain-free survival ranged 2-15 months (median, 5 months; 95% confidence interval [CI]: 0.1, 9.9). The overall response rate was 19 of 19 (100%). The median local control time was 15 months (95% CI: 2.3, 27.7). The 6-, 12-, and 24-month local control rate was 88.0%, 63.2%, and 42.1%, respectively. Twelve patients (70.6%) developed distant metastases and died. Two patients (11.8%) are alive with distant metastases but no evidence of local recurrence. Three patients (17.6%) are alive with no evidence of local recurrence. Median overall survival was 10 months (95% CI: 5.7, 14.3); the 1- and 2-year survival rates were 38.1% and 15.3%, respectively. No major complications related to the procedure occurred during or after brachytherapy.

CONCLUSIONS:

Reirradiation with CT-guided permanent (125)I seed interstitial brachytherapy is feasible, safe, and effective as pain relief or salvage treatment for patients with recurrent retroperitoneal lymph nodes.

• Authors: Lihong Yao, Yuliang Jiang, Ping Jiang, Hao Wang, Na Meng, Ang Qu, Suqing Tian, Haitao Sun, Chen Liu, Junjie Wang, Kaixian Zhang
• Journal: Brachytherapy (Brachytherapy) 2015 Sep-Oct Vol. 14 Issue 5 Pg. 662-9 ISSN: 1873-1449 [Electronic] United States
• PMID: 26138110 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Chemical References

• Iodine Radioisotopes

Topics

• Adult
• Aged
• Brachytherapy (adverse effects, methods)
• Feasibility Studies
• Female
• Humans
• Iodine Radioisotopes (therapeutic use)
• Lymphatic Metastasis (radiotherapy)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (complications, radiotherapy)
• Pain (etiology, prevention & control)
• Radiology, Interventional
• Radiotherapy Dosage
• Retroperitoneal Space
• Survival Rate
• Tomography, X-Ray Computed
• Treatment Outcome