Radioactive 125I Seed Implantation for Recurrent Cervical Carcinoma After Surgery and Radiotherapy: A Case Report

Background: The prognosis of cervical cancer is remarkable, but there are still instances of pelvic and/or extrapelvic recurrence after radical hysterectomy with platinum-based chemoradiotherapy. Sixty percent of the patients with radiotherapy (RT) failure have pelvic recurrence, and 80% of them relapse within two years after treatment. Recurrent cervical cancer seriously affects the prognosis and survival rate of patients. Due to the dose limitation for normal tissue, it is difficult to deliver a sufficient number of doses to recurrent lesions through reirradiation. With the rapid development of brachytherapy technologies such as three-dimensional afterloading brachytherapy, interstitial brachytherapy and radioactive 125I seed implantation, the overall survival (OS) of patients with recurrent cervical cancer has been improving. In the present study, a case in which the patient was successfully treated with radioactive 125I seed implantation is reported.Case presentation: The patient, a 47-year-old woman, was initially diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical cancer and received preoperative radiotherapy, radical hysterectomy, pelvic lymph node dissection and postoperative radiotherapy. After 95 months of follow-up, retroperitoneal lymph node metastasis and edema of the left lower limb . The size of the retroperitoneal lesion was 2.3 × 2.0 cm, and the size of the left supraclavicle lesion was 2.0 × 1.5 cm. Radioactive 125I seed implantation was performed for retroperitoneal lymph node metastasis and left supraclavicular metastasis. Paclitaxel and cisplatin chemotherapy were given after the operation. Three months after implantation, the size of the retroperitoneal focus was 1.5 × 1.1 cm, and the size of the left supraclavicular lesion was 1.0 × 0.6 cm. Thirteen months after implantation, according to the RECIST standard, the therapeutic effect reached CR. At the time of submission, the patient's progression-free survival was 6 years and 4 months.Conclusions: CT-guided 125I seed implantation is a safe, effective, and minimally invasive method for treating patients with recurrent cervical cancer after radiotherapy. The response of this patient indicates that 125I seed implantation can be used as a complementary treatment for recurrent cervical cancer after chemoradiotherapy and may also prove to be reliable for comprehensive treatment of cervical cancer.

miRNA Expression Profiling Regulates Epithelial Mesenchymal Transition in 125I Seed Irradiation of Gastric Carcinoma Cell

Backgroud The aim of this study is to examine miRNA profiling and miR-1285-3p participates in 125I seed irradiation of gastric carcinoma cell via the regulation of epithelial mesenchymal transition (EMT). Methods An in vitro I-125 seed irradiation model was established, followed by the small RNA-Sequencing to investigate the full spectrum of miRNAs that are response to I-125 seed implantation. Validation was performed with quantitative real time PCR (qRT-PCR). qRT-PCR was also employed to measure miR-1285-3p and EMT-related mRNAs expression. Western blotting assay was performed to test the expression of EMT-related proteins. Luciferase reporter assay was conducted to confirm the direct targeting of SMAD2/3 and SMAD4 by miR-1285-3p.Results A total of 1034 miRNAs were initially detected. Of these, 11 miRNAs were significantly differentially expressed between I-125 seed irradiation and control groups. Six miRNAs (hsa-miR-127-3p, hsa-miR-1285-3p, hsa-miR-296-5p, hsa-miR-421, hsa-miR-495-3p, and hsa-miR-548am-3p) were up regulation and five miRNAs (hsa-miR-17-5p, hsa-miR-193b-5p, hsa-miR-23b-5p, hsa-miR-483-5p, hsa-miR-92a-1-5p) were down regulation between I-125 seed irradiation treatment and control groups. EMT is involved in gastric cancer cells treatment with I-125 seed implantation, and downregulation of miR-1285-3p can repress EMT through its targeting of SMAD pathway, which make miR-1285-3p a novel target of I-125 therapeutic intervention for human gastric cancer.Conclusions This study revealed that miR-1285-3p inhibited EMT by targeting SMAD pathway in 125I seed irradiation of gastric carcinoma.

3D Printed Template CT-Guided 125I Seed Implantation In The Treatment Of A Patient With Giant Type A Thymoma: A Case Report

Background: Thymoma, as a malignant tumor with low incidence, is still recommended to be treated with surgery. For middle and advanced patients who can not be treated with surgery, it is recommended to use preoperative radiochemotherapy or chemotherapy. After the tumor regressed, the feasibility of surgical resection will be evaluated. As a new technique developed in recent years, 3D template CT-guided 125I seed implantation has achieved effective results in the treatment of a variety of solid tumors. Case presentation: We report a case of locally advanced giant thymoma (more than 10 cm) who received 3D template CT-guided 125I seed implantation and achieved clinical complete remission. Conclusions: It suggested that radioactive particle implantation may be a new and effective method for the nonoperative treatments of thymoma.

Combined treatment with iodine-125 (125I) seed strand and transarterial chemoembolization (TACE) plus lenvatinib with anti-PD-1 antibodies in patients with unresectable hepatocellular carcinoma (uHCC) and portal vein tumor thrombus (PVTT): Real-world experience in China.

e16152 Background: We reviewed real-world outcomes for patients with uHCC and PVTT receiving TACE with 125I seed and stent implantation combined with lenvatinib plus anti-PD-1 antibodies. Methods: We retrospectively reviewed medical records from 62 consecutive adult (≥18 to ≤75 years) patients with HBV-related HCC and type III and IV PVTT with Child-Pugh class A or B liver function and ECOG performance status of 0-2 who received 125I seed strand and stent implantation combined with TACE at our center between November 2018 and May 2020. Patients were divided into two groups; those who had received adjuvant lenvatinib plus anti-PD-1 inhibitors, initiated 3 days after the first interventional procedure (Group A; n=18), and those who only received locoregional therapy (Group B; n=44). Propensity score matching (PSM) with a 1:1 ratio was used to reduce selection bias. Tumor response, progression-free survival (PFS, time from the first interventional procedure to progression or death for both Group A and Group B) and time-to-progression (TTP) were assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Time to untreatable progression (TTUP) and overall survival (OS) were also assessed. Adverse events (AEs) were graded according to the Common Toxicity Criteria for Adverse Events (CTCAE) v4.0. Results: PSM resulted in 15 matched pairs of patients, and baseline demographic parameters were comparable between the two groups. The median follow-up time was 12.4 ± 4.6 and 9.4 ± 4.8 months for patients in Groups A (n=15) and B (n=15) after PSM, respectively. Compared with patients in Group B, those in Group A had a higher overall response rate (66.7 vs. 18.2%; p=0.001) and disease control rate (72.2 vs. 43.2%; p=.038) and a longer median PFS, TTP, TTUP and OS (Table). No serious complications related to locoregional procedures were reported in either group. In Group A, 13% (n=2) of patients experienced ≥1 AE but the majority were Grade <3; one patient had Grade 2 hyperthyroidism and one had Grade 2 enteritis, which were both considered related to immunotherapy. Conclusions: These real-world data show that 125I seed strand and stent implantation combined with TACE plus adjuvant lenvatinib and anti-PD-1 antibodies led to better treatment responses and survival outcomes compared with locoregional treatment alone in patients with uHCC and PVTT, with an acceptable safety profile. Summary of survival outcomes in propensity score matched groups.[Table: see text]

Similar therapeutic effects of 125I seed radiotherapy and γ-ray radiotherapy on lacrimal gland adenoid cystic carcinoma

AIM: To evaluate the survival outcomes of patients with lacrimal gland adenoid cystic carcinoma who underwent eye-sparing surgery combined with 125I seed implantation radiotherapy or local external γ-ray radiotherapy. METHODS: In this retrospective comparative case series, the clinical records of 27 primary and 8 recurrent patients were reviewed. Univariate and multivariate analyses were used to identify risk factors associated with distant metastasis (DM), and the overall survival (OS) after the initial surgery was analyzed. RESULTS: The median follow-up after radiotherapy was 36mo (range 6-120mo). At the last follow-up after radiotherapy, 26 (74.3%) patients had no evidence of disease, 7 (20%) patients had DM, 2 (5.9%) patients died of DM, and 1 patient with DM was lost to follow-up. Univariate analyses showed that duration of symptoms, bone destruction, T stage classification, and wide excision surgery were risk factors influencing DM (P&#x0026;#x003C;0.05). The 5-year and 10-year OS rates after the initial surgery were 95.8% and 79.9%, respectively. The 5-year DM-free survival and disease-free survival rates after radiotherapy were 66.4% and 52.7%, respectively. CONCLUSION: 125I seed radiotherapy and local external γ-ray radiotherapy may have similar therapeutic effects in preventing DM. Patients with T1/T2 stage disease have a better prognosis than those with T3/T4 stage disease.