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Efficacy of computed tomography-guided 125I seed implantation for treatment of vertebral metastasis of hepatocellular carcinoma



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Efficacy of computed tomography-guided 125I seed implantation for treatment of vertebral metastasis of hepatocellular carcinoma


CHEN Yuxiao HE Chuang YANG Li LI Liangshan HUANG Xuequan

Department of Radiology, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China


125I seeds hepatocellular carcinoma vertebral metastasis


ObjectiveTo evaluate the clinical efficacy of computed tomography (CT)guided 125I seed implantation in the treatment of vertebral metastasis of hepatocellular carcinoma. MethodsThe clinical and imaging data of 16 patients with 23 metastatic tumors were collected. All the patients received CT-guided 125I seed implantation, and the patients’ responses were evaluated by comparing the Karnofsky Performance Status (KPS) scores, Numerical Rating Scale (NRS) scores and American Spinal Injury Association (ASIA) scores before and after the implantation. The patients were followed up for 12 months to record the local tumor control rate and the survival time. Results125I seeds were implanted in all the 23 target lesions with a prescribed dose of 12 000 cGy, a mean gross target volume (GTV) of 22.9±21.4 cc, a median number of implanted seeds of 24 (5 to 50), and a seed radioactive activity of 0.8 mCi(1Ci=3.7×1010Bq). The mean D90 of the target area was 12 399.7±837.4 cGy before and 10 506.2±427.1 cGy after the surgery. At 3 months after the surgery, the patients showed significant improvements in both KPS (P<0.001) scores and NRS scores (P<0.01) with a neurological function recovery rate of 60%. The patients had a median survival time of 8 months with a local tumor control rate of 93.75%, and the patients’ survival rates at 3, 6, and 12 months were 100%, 56.2%, and 12.5%, respectively. None of the patients experienced serious complications during the followup. ConclusionCTguided 125I seed implantation is an effective and safe palliative treatment and can effectively relieve the pain and improve the spinal function in patients with vertebral metastasis of hepatocellular carcinoma.


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Last Update: 2018-07-03