JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2017, Vol. 55 ›› Issue (2): 50-54.doi: 10.6040/j.issn.1671-7554.0.2016.1239

Previous Articles     Next Articles

CT-guided interstitia 125I seed implantation in the treatment of long bone metastasis: a primary clinic study

LI Yang, HE Chuang, CHEN Yuxiao, YANG Li, LI Liangshan, LI Tingyuan, HUANG Xuequan   

  1. Department of Intervention, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
  • Received:2016-09-30 Online:2017-02-10 Published:2017-02-10

PDF (PC)

289

Abstract: Objective To evaluate the clinical efficacy of the implantation of 125I radioactive seeds in the treatment of long bone metastasis. Methods The clinical data of 18 cases were collected along with their imaging data. The lesions located in the humerus(n=8), thighbone(n=14), and fibula(n=1). The patients pain was observed by using the numerical rating scale(NRS), and the functions of patients were investigated with the Musculoskeletal Tumor Society(MSTS)scoring system before and after surgery. The survival rate was described with Kaplan-Meier survival curve. Results All of the 23 radiotherapy targets were implanted with 125I seeds. The gross tumor volume(GTV)was(29.25±22.06)cc, and the radioactive activity of seed was 0.80 mCi. Median number of seeds implanted in lesions was 27(15, 36). The postoperative target verified dose D90 was(11 538.1±1 888.6)cGy. The mean follow-up was 9 months(ranging from 3 to 48 months).The NRS and MSTS scores were both improved significantly during the follow-up(P<0.001, P<0.05). Medium survival time was 10 months, while the survival rate for 6, 12 and 24 months was 70.8%, 41.3% and 23.6%, respectively. Conclusion CT-guided 125I seed implantation is an effective and safe palliative care for long bone metastasis, which can effectively relieve the pain and improve the functions of patients.

Key words: 125I radioactive seeds, Brachytherapy, Long bone metastasis, X-ray computed, Tomography

CLC Number: 

  • R739.93
[1] Wang Z, Wen X, Lu Y, et al. Exploiting machine learning for predicting skeletal-related events in cancer patients with bone metastases[J]. Oncotarget, 2016, 7(11): 12612-12622.
[2] Tsuzuki S, Park SH, Eber MR, et al. Skeletal complications in cancer patients with bone metastases[J]. Int J Urol, 2016, 23(10): 825-832.
[3] Wood TJ, Racano A, Yeung H, et al. Surgical management of bone metastases: quality of evidence and systematic review[J]. Ann Surg Oncol, 2014, 21(13): 4081-4089.
[4] Costelloe CM, Chuang HH, Madewell JE, et al. Cancer response criteria and bone metastases: RECIST 1.1, MDA and PERCIST[J]. J Cancer, 2010, 1: 80-92.
[5] Van der Linden YM, Dijkstra PD, Kroon HM, et al. Comparative analysis of risk factors for pathological fracture with femoral metastases[J]. J Bone Joint Surg Br, 2004, 86(4): 566-573.
[6] Liu XW, Jin P, Liu K, et al. Comparison of percutaneous long bone cementoplasty with or without embedding a cement-filled catheter for painful long bone metastases with impending fracture[J]. Eur Radiol, 2016.[Epub ahead of print]
[7] Mirels H. Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures[J]. Clin Orthop Relat Res, 1989(249): 256-264.
[8] Jawad MU, Scully SP. In brief: classifications in brief: Mirels classification: metastatic disease in long bones and impending pathologic fracture[J]. Clin Orthop Relat Res, 2010, 468(10): 2825-2827.
[9] 汪阳, 张卫国, 蒋林, 等. 髓内钉系统结合骨水泥填充治疗老年股骨转移瘤致股骨病理骨折[J]. 临床急诊杂志, 2015, 16(4): 263-264. WANG Yang, ZHANG Weiguo, JIANG Lin, et al. Intramedullary nail in treatment of elderly patients with metastases to fill the pathological femoral fractures with bone cement[J]. Journal of Clinical Emergency, 2015, 16(4): 263-264.
[10] Ward WG, Spang J, Howe D. Metastatic disease of the femur. surgical management[J]. Orthop Clin North Am, 2000, 31(4): 633-645.
[11] 吴宗明, 唐献忠, 杨庆诚. 四肢骨转移癌126例手术疗效分析[J].中国骨与关节杂志, 2015, 4(5): 343-347. WU Zongming, TANG Xianzhong, YANG Qingcheng. Clinical results in surgical treatment of bone metastases in limbs: 126 cases report[J]. Chinese Journal of Bone and Joint, 2015, 4(5): 343-347.
[12] Keung EZ, Fairweather M, Raut CP. Surgical management of metastatic disease[J]. Surg Clin North Am, 2016, 96(5): 1175-1192.
[13] McDonald R, Probyn L, Poon I, et al. Tumor response after stereotactic body radiation therapy to nonspine bone metastases: an evaluation of response criteria[J]. Int J Radiat Oncol Biol Phys, 2015, 93(4): 879-881.
[14] Westhoff PG, Verdam MG, Oort FJ, et al. Course of quality of life after radiation therapy for painful bone metastases: a detailed analysis from the dutch bone metastasis study[J]. Int J Radiat Oncol Biol Phys, 2016, 95(5): 1391-1398.
[15] 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.
[16] Kouloulias V, Liakouli Z, Zygogianni A, et al. Bone density as a marker of response to radiotherapy in bone metastatic lesions: a review of the published data[J]. Int J Mol Sci, 2016, 17(9). pii: E1391. doi: 10.3390/ijms17091391.
[17] Lutz S, Berk L, Chang E, et al. Palliative radiotherapy for bone metastases: an ASTRO evidence-based guideline[J]. Int J Radiat Oncol Biol Phys, 2011, 79(4): 965-976.
[18] 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. LI Jinxin, ZHANG Qizhou, LI Guoliang. Clinical application of permanent implantation of iodine 125 seeds for osseous metastases[J]. Diagnostic Imaging & Interventional Radiology, 2011, 20(1): 55-57.
[19] 徐绍年, 李福生, 杜振广, 等. 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. XU Shaonian, LI Fusheng, DU Zhenguang, et al. Interstitial 125I seeds implantation in the treatment of osseous metastasis[J]. Chin J Bone Tumor & Bone Disease, 2011, 10(4): 338-342.
[20] 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.
[21] Tatar Z, Soubrier M, Dillies AF, et al. Assessment of the risk factors for impending fractures following radiotherapy for long bone metastases using CT scan-based virtual simulation: a retrospective study[J]. Radiat Oncol, 2014, 9: 227. doi: 10.1186/s13014-014-0227-1.
[22] Saad F, Lipton A, Cook R, et al. Pathologic fractures correlate with reduced survival in patients with malignant bone disease[J]. Cancer, 2007, 110(8): 1860-1867.
[23] Ratasvuori M, Wedin R, Keller J, et al. Insight opinion to surgically treated metastatic bone disease: Scandinavian Sarcoma Group Skeletal Metastasis Registry report of 1195 operated skeletal metastasis[J]. Surg Oncol, 2013, 22(2): 132-138.
[1] WU Mengtao, WU Peng, YANG Yanfei, TANG Dianjun, MIAO Xiangling, LI Fandong. Application of CT venography in the diagnosis and treatment of recurrent lower extremity varicose veins [J]. Journal of Shandong University (Health Sciences), 2020, 1(9): 21-26.
[2] DI Xuemin, NIU Shulei, ZHAO Jing, DU Sui, YU Huimin, ZHANG Hongtao, WANG Juan. CT-guided 125I seed implantation for lymph node metastases in patients with gastric cancer of later stage [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(9): 79-84.
[3] WANG Yuhong, ZHANG Lihong, WANG Linsheng, CHEN Yueqin, WANG Yanhui, WANG Jiehuan, LI Chuanfu. Imaging features of granular cell tumor in the alimentary system [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(8): 66-70.
[4] CAO Qianqian, JIANG Yuhua, LI Yuliang, YANG Ruijie, LIU Lu, ZHANG Xile, WANG Junjie. A dosimetric analysis of cervical metastases between radioactive 125I seeds implantation and external beam radiation therapy [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(7): 55-60.
[5] WANG Weijun, ZHOU Ningquan, WANG Chao. Treatment of 68 cases of moderate volume of hypertensive intracerebral hemorrhage with free hand technique of minimally invasive puncture of the soft channel under CT orientation [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(5): 61-65.
[6] CHAI Shude. Current status and technical innovation of radioactive seed brachytherapy in the treatment of bronchial lung cancer in China [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(2): 4-7.
[7] HUO Bin, WANG Lei, WANG Haitao, HUO Xiaodong, CAO Qiang, WANG Lili, ZANG Li, WANG Jinhuan, ZHENG Guanjun, CHAI Shude. Feasibility of radioactive seed implantation in the treatment of lung cancer assisted by template combined with rib drilling technique [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(2): 26-31.
[8] DAI Jianjian, YUAN Bing, ZHANG Ying, LIN Qi, YUAN Yuan, HAN Mingyong. CT-guided percutaneous 125I seed implantation brachytherapy in patients with stage Ⅲ non-small-cell lung cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(2): 32-37.
[9] SHEN Wenjiang. Radioactive seeds implantation in tumor treatment [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(2): 1-3.
[10] YUE Qianqian, WANG Xinyi, YANG Zhiqiang, JIANG Shu. Quantitative analysis of spectral CT imaging on hypervascular hepatic metastasis and hepatocellular carcinoma [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(7): 50-55.
[11] MENG Xiangshui, CHAI Xiangjun, MA Xiangxing, REN Qingguo, YANG Zhicheng. Value of CT and MRI in the treatment options of laryngeal cancer [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(10): 76-79.
[12] LIU Qing, SHANG Mengmeng, SUN Xiao, LI Jie, YANG Jie, SHI Dandan, NING Song. Effects of chemical composition of urinary stones on their acoustic shadowing [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(9): 19-23.
[13] LIU Lu, LI Rongrong, LIU Mengjun, ZHANG Yan, LIU Dongxu. Alveolar bone volume around upper incisors in adult patients with Class Ⅰ bimaxillary protrusion [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(8): 66-70.
[14] CHEN Xueling, WU Zizhong, LIU Dongxu, XIE Yongtao, GUO Tiantian, ZHANG Shijie. CBCT evaluation of the upper airway morphological changes in skeletal Class Ⅲ malocclusion patients using protraction and rapid maxillary expansion appliance [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(8): 71-78.
[15] FENG Xiaoyu, ZHANG Hongmei, CHE Xuanqiang, KANG Donghong. Therapeutic effects of human osteoblast-stimulating factor on osteoporosis of ovariectomized rats [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(7): 8-12.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd