|The investigation of I-125 seed implantation as a salvage modality for unresectable pancreatic carcinoma|
|Wang, Hao1; Wang, Junjie1; Jiang, Yuliang1; Li, Jinna1; Tian, Suqing1; Ran, Weiqiang2; Xiu, Dianrong3; Gao, Yang1|
|关键词||I-125 seed Intraoperative implantation Ultrasound-guided Unresectable Pancreatic carcinoma|
|刊名||JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH|
|WOS标题词||Science & Technology|
|关键词[WOS]||EXTERNAL-BEAM RADIATION ; PROTRACTED 5-FLUOROURACIL INFUSION ; PHASE-II ; INTRAOPERATIVE RADIOTHERAPY ; CONCURRENT RADIOTHERAPY ; SURGICAL RESECTION ; BYPASS PROCEDURES ; I125 IMPLANT ; CANCER ; ADENOCARCINOMA|
Background: To assess the efficacy of intraoperative ultrasound-guided implantation of I-125 seeds for the treatment of unresectable pancreatic carcinoma, and analyze the associated prognostic factors.
Methods: Twenty-eight patients with pancreatic carcinoma who underwent laparotomy and were considered to have unresectable tumors were included in this study. Nine patients were pathologically diagnosed with Stage II disease, and nineteen patients with Stage III disease. Twenty-eight patients received intraoperative ultrasound-guided I-125 seed implantation and received a D-90 (at least 90% of the tumor volume received the reference dose) ranging from 60 to 163 Gy, with a median of 120 Gy. Seven patients received an additional 35-50 Gy external beam radiotherapy after seed implantation, and ten patients received two to ten cycles of chemotherapy. Overall survival of the patients was calculated and prognostic factors were evaluated.
Results: Of the patients, 94.1% (16/17) achieved good to medium pain relief. The tumor response rate was 78.6% (22/28), and local control was achieved in 85.7% (24/28) of patients. The 1-, 2- and 3-year survival rates were 30%, 11% and 4%, and the median survival was 10.1 months (95% CI: 9.0-10.9). Analysis using the Cox proportional hazards model suggested that patients younger than 60 years and patients who received a D-90 higher than 110 Gy may survive for a longer period.
Conclusions: I seed implantation provides a safe and effective method to relieve pain, control local tumor growth and, to some extent, prolong the survival of patients with stage II and III pancreatic disease, without additional complications. Age and accumulated dose may be factors predictive of a favorable outcome for patients with unresectable pancreatic carcinoma treated with I-125 seeds. These findings need to be validated by conducting further studies with larger cohorts.
|资助机构||National Science Foundation of China|
|作者单位||1.Peking Univ, Hosp 3, Dept Surg, Beijing 100083, Peoples R China|
2.Peking Univ, Hosp 3, Dept Radiat Oncol, Beijing 100083, Peoples R China
3.Peking Univ, Hosp 3, Dept Ultrasound, Beijing 100083, Peoples R China
|Wang, Hao,Wang, Junjie,Jiang, Yuliang,et al. The investigation of I-125 seed implantation as a salvage modality for unresectable pancreatic carcinoma[J]. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH,2013,32.|
|APA||Wang, Hao.,Wang, Junjie.,Jiang, Yuliang.,Li, Jinna.,Tian, Suqing.,...&Gao, Yang.(2013).The investigation of I-125 seed implantation as a salvage modality for unresectable pancreatic carcinoma.JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH,32.|
|MLA||Wang, Hao,et al."The investigation of I-125 seed implantation as a salvage modality for unresectable pancreatic carcinoma".JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH 32(2013).|