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.

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.

The dosimetry evaluation of 3D printing non-coplanar template-assisted CT-guided 125I seed stereotactic ablation brachytherapy for pelvic recurrent rectal cancer after external beam radiotherapy

ABSTRACT The aim of this study was to investigate the safety and accuracy of computed tomography (CT)-guided 125I seed implantation assisted by a three-dimensional printing non-coplanar template (3D-PNCT) for treating pelvic locally recurrent rectal cancer (LRRC) patients. A total of 13 patients with 18 masses received 125I seed implantation. The dosimetric parameters of pre-implantation and post-implantation were calculated to evaluate the quality of 125I seed implantation. Doses delivered to the organs at risk (OAR) were also calculated. Differences between pre-implantation and post-implantation were compared by the paired t-test. The mean number of 125I seeds pre-implantation and post-implantation was 67.1 and 68.8, respectively. The mean values of D90 (dose that was delivered to 90% of the target volume), D100 (dose that was delivered to 100% of the target volume), V100 (the target volume receiving 100% of the prescription dose) and V150 (the target volume receiving 150% of the prescription dose) pre-implantation and post-implantation were 136.6 and 135.2 Gy, 63.5 and 71.0 Gy, 90.3% and 90.3% and 62.1% and 62.2%, respectively. Dosimetric outcomes were evaluated quantitatively using the dose volume indices, i.e. coverage index (CI), external volume index (EI) and relative dose homogeneity index (HI). The mean values of those indices pre-implantation and post-implantation were 0.62 and 0.61, 0.31 and 0.33, and 0.31 and 0.31, respectively. The mean doses delivered to OAR pre-implantation and post-implantation for the bladder (D2cc) and bowel (D2cc) were 33.4 and 34.4 Gy, and 58.6 and 61.8 Gy, respectively. The parameters mentioned above fitted well, and no significant difference was found among them. It is concluded that CT-guided 125I seed implantation assisted by 3D-PNCT could be a safe and accurate salvage modality for treating LRRC patients; the ideal pre-prescription dose could be achieved. Also, addition of 3D-PNCT could minimize radiation damage to the surrounding normal tissues.

Clinical analysis of 125I seed implantation combined with Apatinib in the treatment of locally advanced lung cancer: a case series

This clinical analysis of 125I seed implantation combined with Apatinib in the treatment of locally advanced lung cancer with negative driving genes was retrospectively performed on 19 patients in the Department of Thoracic Surgery, Tianjin First Central Hospital, from January 2018 to May 2019. Twelve cases were treated with Apatinib after 125I implantation, while the other seven were treated with 125I implantation only. IL-2R, IL-6 and TNF-? before and after the treatment, imaging changes every two months and related side effects were recorded. After the treatment, IL-2R, IL-6 and TNF-? of all the patients decreased in the first month, which was more obvious in combined therapy patients; the total effective rate in combined therapy patients was significantly higher than the others. There were no fatal complications, and all the side-effects were well tolerated by medical treatment. Continuous....