|Table of Contents|

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

(PDF)

《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

Issue:
2018年第12期
Page:
1130-1135
Research Field:
临床医学
Publishing date:

Info

Title:

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

Author(s):

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

Keywords:

125I seeds hepatocellular carcinoma vertebral metastasis
 

PACS:
R730.55;R735.7;R738.1
DOI:
-
Abstract:

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.

References:

[1]吕桂帅,陈磊, 王红阳. 我国肝癌研究的现状与前景[J]. 生命科学, 2015, 27(3): 237-248. DOI: 10.13376/j.cbls/2015034.
LYU G S, CHEN L, WANG H Y. Research progress and prospect of liver cancer in China[J]. Chin Bull Life Sci, 2015, 27(3): 237-248. DOI: 10.13376/j.cbls/2015034.
[2]GOODWIN C R, YANAMADALA V, RUIZVALLS A, et al. A systematic review of metastatic hepatocellular carcinoma to the spine[J]. World Neurosurg, 2016 , 91: 510-517, e4. DOI: 10.1016/j.wneu.2016.04.026.
[3]COSTELLOE C M, CHUANG H H, MADEWELL J E, et al. Cancer response criteria and bone metastases: RECIST 1.1, MDA and PERCIST[J]. J Cancer, 2010, 1: 80-92. DOI:10.7150/jca.1.80.
[4]NATER A, SAHGAL A, FEHLINGS M. Management—spinal metastases[J]. Handb Clin Neurol, 2018, 149: 239-255. DOI: 10.1016/B9780128111611.000165.
[5]OVERCASH J, HANES D, BIRKHIMER D, et al. Pain intensity and pain management of hospitalized patients with cancer: an opportunity for improvement[J]. Clin J Oncol Nurs, 2013, 17(4): 365-368. DOI: 10.1188/13.CJON.365368.
[6]李晨曦. 晚期肝癌患者对索拉非尼耐药机制的研究进展[J]. 解放军医学院学报, 2017, 38(4): 381-384. DOI: 10.3969/j.issn.20955227.2017.04.025.
LI C X. Mechanism of sorafenib resistance in hepatocellular carcinoma[J]. Acad J PLA Postgraduate Med School, 2017, 38(4): 381-384. DOI: 10.3969/j.issn.20955227.2017.04.025.
[7]LUTZ S, BALBONI T, JONES J, et al. Palliative radiation therapy for bone metastases: update of an ASTRO evidencebased guideline[J]. Pract Radiat Oncol, 2017, 7(1): 4-12. DOI: 10.1016/j.prro.2016.08.001.
[8]POTTERS L, MORGENSTERN C, CALUGARU E, et al. 12year outcomes following permanent prostate brachytherapy in patients with clinically localized prostate cancer[J]. J Urol, 2008, 179(5 Suppl): S20-S24. DOI: 10.1016/j.juro.2008.03.133.
[9]FEHLINGS M G, NATER A, TETREAULT L, et al. Survival and clinical outcomes in surgically treated patients with metastatic epidural spinal cord compression: results of the prospective multicenter AOSpine study[J]. J Clin Oncol, 2016, 34(3): 268-276. DOI: 10.1200/JCO.2015.61.9338.
[10]QURAISHI N A, AREALIS G, SALEM K M, et al. The surgical management of metastatic spinal tumors based on an epidural spinal cord compression (ESCC) scale[J]. Spine J, 2015, 15(8): 1738-1743. DOI: 10.1016/j.spinee.2015.03.040.
[11]伍星星, 王文军. 125Ⅰ放射性粒子在脊柱肿瘤中的应用研究现状[J]. 中国矫形外科杂志, 2015, 23:1396-1399.DOI: 10.3977/j.issn.10058478.2015.15.13.
WU X X, WANG W J. Situation of application of radioiodine125 seeds in the spinal tumors[J]. Orthopedic J China, 2015, 23: 1396-1399. DOI: 10.3977/j.issn.10058478.2015.15.13.
[12]BLASKO J C, MATE T, SYLVESTER J E, et al. Brachytherapy for carcinoma of the prostate: techniques, patient selection, and clinical outcomes[J]. Semin Radiat Oncol, 2002, 12(1): 81-94. DOI: 10.1053/srao.2002.28667.
[13]王俊杰, 张福君. 肿瘤放射性粒子治疗规范[M]. 北京:人民卫生出版社, 2016:143.
WANG J J, ZHAN F J. Standard for radioactive seed implantation therapy tumor[M]. Beijing: People’s Medical Publishing House, 2016: 143.
[14]李锦新, 张启周 , 栗国梁. 125Ⅰ放射性粒子植入治疗骨转移瘤的临床观察[J]. 影像诊断与介入放射学, 2011, 20(1): 55-57. DOI: 10.3969/issn.10058001.2011.01.014.
LI J X, ZHANG Q Z, LI G L. Clinical application of permanent implantation of iodine 125 seeds for osseous metastases[J]. Diag Imag Interv Radiol, 2011, 20(1): 55-57. DOI: 10.3969/issn.10058001.2011.01.014.
[15]徐绍年, 李福生 , 杜振广. 125Ⅰ粒子组织间植入治疗骨转移瘤的临床研究[J]. 中国骨肿瘤骨病, 2011,10(4): 338-342. DOI: 10.3969/j.issn.16711971.2011.04.003.
XU S N, LI F S, DU Z G. Interstitial 125Ⅰ seeds implantation in the treatment of osseous metastasis[J]. Chin J Bone Tumor Bone Dis, 2011,10(4): 338-342. DOI: 10.3969/j.issn.16711971.2011.04.003.
[16]YANG Z, TAN J, ZHAO R, et al. Clinical investigations on the spinal osteoblastic metastasis treated by combination of percutaneous vertebroplasty and (125)I seeds implantation versus radiotherapy[J]. Cancer Biother Radiopharm, 2013, 28(1): 58-64. DOI: 10.1089/cbr.2012.1204.
[17]TSUZUKI S, PARK S H, EBER M R, et al. Skeletal complications in cancer patients with bone metastases[J]. Int J Urol, 2016, 23(10): 825-832. DOI: 10.1111/iju.13170.
[18]WANG S, SHI G, MENG X. Clinical curative effect of percutaneous vertebroplasty combined with 125Ⅰseed implantation in treating spinal metastatic tumor[J]. Pak J Pharm Sci, 2015, 28(3 Suppl): 1039-1042.
[19]程琳, 何闯, 刘云, 等. 放射性125Ⅰ粒子联合经皮椎体成形术治疗椎体转移瘤的应用研究进展[J]. 局解手术学杂志, 2017, 26(7): 535-538. DOI:10. 11659/jjssx.03E017089.
CHENG L, HE C, LIU Y, et al. Progress on application of 125Ⅰ seeds and percutaneous vertebraplasty for vertebral metastases[J]. J Reg Anat Oper Surg, 2017, 26(7): 535-538. DOI: 10.11659/jjssx.03E017089.

Memo

Memo:
-
Last Update: 2018-07-03