Percutaneous computed tomography/ultrasonography-guided permanent iodine-125 implantation as salvage therapy for recurrent squamous cell cancers of head and neck.

Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, PR China.
Cancer biology & therapy (Impact Factor: 3.29). 06/2010; 9(12):959-66. DOI: 10.4161/cbt.9.12.11700
Source: PubMed

ABSTRACT To assess the feasibility, efficacy, and morbidity of permanent percutaneous 125I seed implantation under computed tomography (CT)/ultrasonography guidance for recurrent squamous cell carcinomas of head and neck.
Twenty-five patients underwent 125I seed implantation under CT or ultrasonography guidance. Postoperative dosimetry was routinely performed for all the patients. The actuarial D90 of the implanted 125I seeds ranged from 90 Gy to 160 Gy (median: 130 Gy). The activity of 125I seed ranged from 0.35 mCi to 0.8 mCi (median: 0.6 mCi). The total number of seeds implanted ranged from 3 to 61 (median: 22). The follow-up period ranged from 3 to 40 months (median: 8 months).
The median local disease-free progression was 12 months (95% CI, 4.8-19.2), and the 1- and 2-year local tumor control rates were 48.7% and 39.9%, respectively. The 1- and 2-year survival rates were 42.5% and 28.3%, respectively (median: 11 months) (95% CI, 8.2-13.8). Of the 25 patients, 6 (24%) died of local recurrence and 5 (20%) died of metastases; 2 patients showed recurrences at 3 and 8 months after seed implantation and subsequently died of pneumonia. One patient died of heart disease. One developed ulceration with tumor progression. Blood vessel damage and neuropathy were not observed.
The high local tumor control rates, minimal invasion, and low morbidity suggest that percutaneous 125I seed implantation is a feasible and safe salvage for patients with recurrent squamous cell carcinomas of the head and neck.

  • [Show abstract] [Hide abstract]
    ABSTRACT: External beam radiation (EBRT) and (125)I seeds continuous low dose rate radiation (CLDR) were used to treat patients with lung cancer. We herein investigated the biological effects of EBRT and CLDR on lung cancer cells. A549 human lung cancer cell line was thus exposed to different doses of EBRT and CLDR. CLDR was more efficient to inhibit cell growth than EBRT. CLDR induced increased DNA damage as evidenced by long-lasting p-H2AX activity. The enhanced inhibitory effects of CLDR on lung cancer cell growth may be, at least in part, due to the increased Bax/Bcl2 ratio and cyclin B1-mediated G2/M arrest.
    Cancer Investigation 04/2014; · 2.24 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although radiotherapy technology has progressed rapidly in the past decade, the inefficiency of radiation and cancer cell resistance mean that the 5-year survival rate of patients with nasopharyngeal carcinoma (NPC) is low. Radioactive (125)I seed implantation has received increasing attention as a clinical treatment for cancers. Vascular endothelial growth factor-A (VEGF-A) is one of the most important members of the VEGF family and plays an important role in cell migration through the extracellular-signal-regulated kinase (ERK) pathway. Here we show that radioactive (125)I seeds more effectively inhibit NPC cell growth through DNA damage and subsequent induction of apoptosis, compared with X-ray irradiation. Moreover, cell migration was effectively inhibited by (125)I seed irradiation through VEGF-A/ERK inactivation. VEGF-A pretreatment significantly blocked (125)I seed irradiation-induced inhibition of cell migration by recovering the levels of phosphorylated ERK (p-ERK) protein. Interestingly, in vivo study results confirmed that (125)I seed irradiation was more effective in inhibiting tumor growth than X-ray irradiation. Taken together, these results suggest that radioactive (125)I seeds exert novel anticancer activity by triggering DNA damage and inactivating VEGF-A/ERK signaling. Our finding provides evidence for the efficacy of (125)I seeds for treating NPC patients, especially those with local recurrence.
    PLoS ONE 01/2013; 8(9):e74038. · 3.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study is to evaluate the therapeutic efficacy of computed tomography (CT)-guided interstitial iodine-125 (I) seed implantation for metastatic malignant melanoma treatment. From November 2008 to May 2011, 24 patients with metastatic malignant melanoma who had undergone surgery for excision of primary lesions and repeated chemotherapy underwent CT-guided I seed implantation. Their clinical situations, biochemical indicators, MRIs, and CTs were observed. The follow-up time ranged from 5 to 24 months (mean 19.6 months). The local control rates of metastatic malignant melanoma after surgery excision for primary lesion after 2, 6, 12, and 24 months were 86.8, 78.6, 62.1, and 55.0%, respectively. One patient died of liver failure 5 months after brachytherapy and another died of a metastatic brain tumor 8 months after brachytherapy. Two patients died of lung dysfunction from pulmonary metastases 15 months after brachytherapy. All other patients survived throughout the follow-up period. The 2-year survival rate was 83.3%. During the procedure, one patient presented with minimal bleeding from the applicator route and another presented with pneumothorax with 20% pulmonary compression, which improved after intraprocedure suctioning. Four patients had low-grade fever on day 3. Three showed mild decreases in their white blood cell counts. CT-guided I seed implantation is a safe, feasible, and promising approach to the treatment of patients with metastatic malignant melanoma after surgery excision for primary lesions and repeated chemotherapy, but large-scale randomized clinical trials should be conducted before the technique can be used routinely.
    Melanoma research 04/2014; 24(2):137-43. · 2.06 Impact Factor