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Barranquero AG, Corral Moreno S, Martínez Lorca A, Hernández-Cosido L, Rioja Martín ME, Mena Mateo A, Cabañas Montero J, Fernández-Cebrián JM. Radioguided surgery of mesenchymal tumors with 125I seeds. Rev Esp Med Nucl Imagen Mol 2023; 42:296-301. [PMID: 37062451 DOI: 10.1016/j.remnie.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION Radioguided surgery uses radioactive substances to identify and remove hard-to-locate lesions. Mesenchymal tumors constitute a heterogeneous group of neoplasms derived from the mesoderm, including benign lesions and malignant sarcomas. The aim of this study was to evaluate the ability of 125I radioactive seeds to guide intraoperative localization of mesenchymal tumors, analyzing the complication rates and evaluating the margins of the surgical specimens retrieved. METHODS Retrospective observational study of all consecutive patients undergoing radioguided surgery of a mesenchymal tumor with a 125I radioactive seed from January 2012 to January 2020 at a tertiary referral center in Spain. The seed was inserted percutaneously guided by ultrasound or computed tomography in an outpatient setting. RESULTS Fifteen lesions were resected in 11 interventions in 11 patients, recovering all lesions marked (100%) with a 125I seed. The lesions included areas of benign fibrosis (26.7%), cellular angiofibroma (6.7%), desmoid tumor (20%), solitary fibrous tumor (13.3%), chondrosarcoma (6.7%), and pleomorphic sarcoma (26.7%), with a high rate of recurrent tumors (60%). There was only one complication (6.7%) due to the seed falling within the surgical bed. According to the UICC classification of residual tumors, 80% of the lesions resulted in an R0 resection, 6.7% were R1 resections, and 13.3% were R2 resections. CONCLUSION Radioguided surgery is an accurate technique for the resection of hard-to-locate mesenchymal tumors.
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Affiliation(s)
- Alberto G Barranquero
- Cirugía General y del Aparato Digestivo, Hospital Universitari Arnau de Vilanova, Lleida, Spain.
| | - Sara Corral Moreno
- Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | | | - Antonio Mena Mateo
- Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Jacobo Cabañas Montero
- Cirugía General y del Aparato Digestivo, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Sheng Y, Fu X, Wang G, Mu M, Jiang W, Chen Z, Qi H, Gao F. Safety and efficacy of self-expandable metallic stent combined with 125I brachytherapy for the treatment of malignant obstructive jaundice. Cancer Imaging 2023; 23:33. [PMID: 37016400 PMCID: PMC10071611 DOI: 10.1186/s40644-023-00551-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/27/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Several previous studies demonstrated that the combination of self-expandable metallic stents (SEMS) and 125I seed implantation might prolong stent patency and obtain survival benefits for malignant obstructive jaundice (MOJ) patients. However, these studies rarely mentioned a comparison between CT-guided intratumoral 125I seed implantation and intraluminal 125I seed strand insertion combined with stenting for the management of MOJ. This study aimed to further evaluate the safety and efficacy of SEMS combined with 125I brachytherapy in the management of unresectable MOJ. METHODS Fifty-nine patients with unresectable MOJ were retrospectively included from March 2018 to June 2021. The main therapeutic outcomes were evaluated in terms of stent patency, and overall survival. Cumulative stent patency and overall survival rates were calculated by Kaplan-Meier survival analysis. Both clinical and treatment factors associated with survival were analyzed. RESULTS Technical success was achieved in all patients. The clinical success rate was 94% (32/34) in the seeds group and 92% (23/25) in the control group, no significant difference was found (p =1.000). The median duration of stent patency was significantly longer in the 125I brachytherapy group compared with the control group (289 days vs. 88 days, respectively, p =0.001). The 125I brachytherapy group demonstrated a significantly better median overall survival rate than the control group (221 days vs. 78 days, respectively, p =0.001). In multivariate analysis, stents with 125I brachytherapy (p =0.004) was a significant favorable prognostic factor that affected patient survival. No significant difference was observed between CT-guided 125I seed implantation and 125I seed strand insertion in stent patency (p =0.268), and overall survival (p =0.483). CONCLUSION SEMS combined with 125I brachytherapy is safe and effective for treating MOJ. 125I brachytherapy may help to maintain stent patency and prolong overall survival. There was no significant difference between CT-guided 125I seed implantation with SEMS and 125I seed strand insertion with SEMS in stent patency and overall survival.
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Affiliation(s)
- Ye Sheng
- Department of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center and Sun Yat-sen University State Key Laboratory of Oncology in South China, and Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
- Department of Interventional Radiology, The Third Affiliated Hospital of Soochow University and The First People's Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Xiaobo Fu
- Department of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center and Sun Yat-sen University State Key Laboratory of Oncology in South China, and Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Guobao Wang
- Department of Endoscopy, Sun Yat-sen University Cancer Center and Sun Yat-sen University State Key Laboratory of Oncology in South China, and Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Maoyuan Mu
- Department of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center and Sun Yat-sen University State Key Laboratory of Oncology in South China, and Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Weiwei Jiang
- Department of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center and Sun Yat-sen University State Key Laboratory of Oncology in South China, and Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Zixiong Chen
- Department of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center and Sun Yat-sen University State Key Laboratory of Oncology in South China, and Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
| | - Han Qi
- Department of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center and Sun Yat-sen University State Key Laboratory of Oncology in South China, and Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
| | - Fei Gao
- Department of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center and Sun Yat-sen University State Key Laboratory of Oncology in South China, and Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
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Wang H, Shi HB, Qiang WG, Wang C, Sun B, Yuan Y, Hu WW. CT-guided Radioactive 125I Seed Implantation for Abdominal Incision Metastases of Colorectal Cancer: Safety and Efficacy in 17 Patients. Clin Colorectal Cancer 2023; 22:136-142. [PMID: 36463020 DOI: 10.1016/j.clcc.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION To retrospectively evaluate the safety and efficacy of computed tomography (CT)-guided iodine-125 (125I) seed implantation for patients with abdominal incision metastases from colorectal cancer. MATERIALS AND METHODS Data of patients with abdominal incision metastases of colorectal cancer from November 2010 to October 2020 were retrospectively reviewed. Each incisional metastasis was percutaneously treated with 125I seed implantation under CT guidance. Follow-up contrast-enhanced CT was reviewed, and the outcomes were evaluated in terms of objective response rate, complications, and overall survival. RESULTS A total of 17 patients were enrolled in this study. The median follow-up was 18 months (range, 2.7-22.1 months). At 3, 6, 12, and 18 months after the treatment, objective response rate was 52.9%, 63.6%, 33.3%, and 0%, respectively. A small amount of local hematoma occurred in two patients and resolved spontaneously without any treatment. Two patients experienced a minor displacement of radioactive seeds with no related symptoms. Severe complications, such as massive bleeding and radiation injury, were not observed. No ≥ grade 3 adverse events were identified. By the end of follow-up, 14 patients died of multiple hematogenous metastases. The one-year overall survival rate was 41.6%, and the median overall survival was 8.6 months. CONCLUSION CT-guided 125I seed implantation brachytherapy is safe and feasible for patients with abdominal incision metastases from colorectal cancer.
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Affiliation(s)
- Hao Wang
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Hong-Bing Shi
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Wei-Guang Qiang
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Chao Wang
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Bai Sun
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Ye Yuan
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Wen-Wei Hu
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China.
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Ren F, Li B, Wang C, Wang Y, Cui B. Iodine-125 seed represses the growth and facilitates the apoptosis of colorectal cancer cells by suppressing the methylation of miR-615 promoter. BMC Cancer 2022; 22:49. [PMID: 34998382 PMCID: PMC8742920 DOI: 10.1186/s12885-021-09141-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 12/21/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) represents a common malignancy in gastrointestinal tract. Iodine-125 (125I) seed implantation is an emerging treatment technology for unresectable tumors. This study investigated the mechanism of 125I seed in the function of CRC cells. METHODS The CRC cells were irradiated with different doses of 125I seed (0.4, 0.6 and 0.8 mCi). miR-615 expression in CRC tissues and adjacent tissues was detected by RT-qPCR. miR-615 expression was intervened with miR-615 mimic or miR-615 inhibitor, and then the CRC cells were treated with 5-AZA (methylation inhibitor). The CRC cell growth, invasion and apoptosis were measured. The methylation level of miR-615 promoter region was detected. The xenograft tumor model irradiated by 125I seed was established in nude mice. The methylation of miR-615, Ki67 expression and CRC cell apoptosis were detected. RESULTS 125I seed irradiation repressed the growth and facilitated apoptosis of CRC cells in a dose-dependent manner. Compared with adjacent tissues, miR-615 expression in CRC tissues was downregulated and miR-615 was poorly expressed in CRC cells. Overexpression of miR-615 suppressed the growth of CRC cells. 125I seed-irradiated CRC cells showed increased miR-615 expression, reduced growth rate and enhanced apoptosis. The methylation level of miR-615 promoter region in CRC cells was decreased after 125I seed treatment. In vivo experiments confirmed that 125I seed-irradiated xenograft tumors showed reduced methylation of the miR-615 promoter and increased miR-615 expression, as well as decreased Ki67 expression and enhanced apoptosis. The target genes of miR-615 and its regulatory downstream pathway were further predicted by bioinformatics analysis. CONCLUSIONS 125I seed repressed the growth and facilitated the apoptosis of CRC cells by suppressing the methylation of the miR-615 promoter and thus activating miR-615 expression. The possible mechanism was that miR-615-5p targeted MAPK13, thus affecting the MAPK pathway and the progression of CRC.
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Affiliation(s)
- Fenghai Ren
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, 150081, Heilongjiang, China
| | - Baojun Li
- Department of Head and Neck Surgery, Harbin Medical University Cancer Hospital, Harbin, 150081, Heilongjiang, China
| | - Chao Wang
- Department of Prenatal Diagnosis, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Yanbo Wang
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, 150081, Heilongjiang, China
| | - Binbin Cui
- Department of Colorectal Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, Harbin, 150081, Heilongjiang, China.
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Frost R, Reed AJ, Dessauvagie BF, Taylor DB. Pre-operative localization of impalpable breast lesions using iodine 125 seeds: Placement accuracy and multidisciplinary challenges. Clin Imaging 2020; 73:124-133. [PMID: 33387917 DOI: 10.1016/j.clinimag.2020.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/28/2020] [Accepted: 12/17/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The number of impalpable breast lesions requiring pre-operative lesion localization (PLL) continues to increase. The use of Radio-guided Occult Lesion Localization with Iodine 125 Seeds (ROLLIS) offers multiple benefits for the multidisciplinary team (MDT), but is not without challenges. AIMS The aims of this audit were to review our multidisciplinary team's experience following introduction of ROLLIS as standard of care for PLL, identify challenges and evaluate seed placement accuracy (SPA). RESULTS/OUTCOMES Over a nineteen month period, 327 seeds were inserted: 96% of single seed localizations were within 10 mm, 91% within 5 mm and 42% within or in contact with the lesion (or marker clip surrogate) on post-insertion two view mammography. Each component of the MDT reported on benefits of the ROLLIS program and challenges faced. Examples included: an undetectable seed in the operating room, a seed damaged in pathology during specimen processing, suboptimal seed position requiring hook-wire localization (HWL) and delayed seed removal in a patient who initially refused to return for surgery. CONCLUSION ROLLIS results in high seed placement accuracy. Despite clear advantages, use of ROLLIS presents some multidisciplinary challenges. Robust patient information, training of new staff and adherence to strict policies and protocols are required to ensure safe delivery of a ROLLIS program.
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Affiliation(s)
- Rosanna Frost
- Department Diagnostic & Interventional Radiology, Royal Perth Hospital, 3rd Floor, North Block, Wellington Street, Perth, Western Australia, Australia
| | - Anita J Reed
- Department of Clinical Physics, Royal Perth Hospital, Wellington Street, Perth, Western Australia, Australia
| | - Benjamin Frederik Dessauvagie
- Anatomical Pathology, PathWest Laboratory Medicine Fiona Stanley Hospital, Murdoch, Western Australia, Australia; Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
| | - Donna Blanche Taylor
- Department Diagnostic & Interventional Radiology, Royal Perth Hospital, 3rd Floor, North Block, Wellington Street, Perth, Western Australia, Australia; BreastScreen WA, Adelaide Terrace, Perth, Western Australia, Australia; Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia.
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Li W, Wang X, Wang Z, Zhang T, Cai F, Tang P, Meng J, Du H, Wang H, Li M, Li S. The role of seed implantation in patients with unresectable pancreatic carcinoma after relief of obstructive jaundice using ERCP. Brachytherapy 2020; 19:97-103. [PMID: 31564517 DOI: 10.1016/j.brachy.2019.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/27/2019] [Accepted: 08/21/2019] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of the study was to investigate the role of iodine-125 seed implantation, guided by endoscopic ultrasound (EUS) and/or percutanous ultrasound, in patients with unresectable pancreatic carcinoma after relief of obstructive jaundice using endoscopic retrograde cholangiopancreatography (ERCP). METHODS AND MATERIALS A total of 101 patients with obstructive jaundice due to unresectable pancreatic carcinoma were enrolled between January 2010 and December 2017 in this retrospective study. Of these patients, 50 underwent implantation of iodine-125 seeds under EUS and/or percutaneous ultrasound guidance after receiving a stent via ERCP (treatment group), and 51 received a stent via ERCP without undergoing seed implantation (control group). The clinical data and therapeutic outcomes of these patients were analyzed. RESULTS Compared with the control group, the treatment group obtained significant relief of abdominal pain at the 1-week, 1-month, and 3-month followup (p < 0.05), with a significantly lower visual analog scale pain score (p < 0.05). The treatment group obtained a longer median survival (8.8 vs. 6.5 months, p = 0.02), longer median duration of stent patency (10.8 ± 1.4 vs. 6.9 ± 0.8 months, p = 0.02), and prolonged average time to gastric outlet obstruction (6.8 ± 1.6 vs. 5.3 ± 1.3 months, p = 0.02). Differences between liver function and appetite for the two groups were not significant (p > 0.05 and p = 0.59, respectively). CONCLUSIONS Iodine-125 seed implantation after relief of obstructive jaundice via ERCP prolongs survival, biliary stent patency, and time to gastric outlet obstruction and improves patient quality of life by relieving pancreatic pain in patients with unresectable pancreatic carcinoma.
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Affiliation(s)
- Wen Li
- Department of Gastroenterology and Hepatology, The Chinese PLA General Hospital, Beijing, China
| | - Xiangdong Wang
- Department of Gastroenterology and Hepatology, The Chinese PLA General Hospital, Beijing, China
| | - Zikai Wang
- Department of Gastroenterology and Hepatology, The Chinese PLA General Hospital, Beijing, China
| | - Tiantian Zhang
- Department of Gastroenterology and Hepatology, The Chinese PLA General Hospital, Beijing, China
| | - Fengchun Cai
- Department of Gastroenterology and Hepatology, The Chinese PLA General Hospital, Beijing, China
| | - Ping Tang
- Department of Gastroenterology and Hepatology, The Chinese PLA General Hospital, Beijing, China
| | - Jiangyun Meng
- Department of Gastroenterology and Hepatology, The Chinese PLA General Hospital, Beijing, China
| | - Hong Du
- Department of Gastroenterology and Hepatology, The Chinese PLA General Hospital, Beijing, China
| | - Hongbin Wang
- Department of Gastroenterology and Hepatology, The Chinese PLA General Hospital, Beijing, China
| | - Mingyang Li
- Department of Gastroenterology and Hepatology, The Chinese PLA General Hospital, Beijing, China
| | - Shuling Li
- Department of Gastroenterology and Hepatology, The Chinese PLA General Hospital, Beijing, China.
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Qin J, Zhu HD, Guo JH, Ni CF, Wu P, Xu H, Mao AW, Lu J, Su C, Teng GJ. Factors associated with overall survival and relief of dysphagia in advanced esophageal cancer patients after 125I seed-loaded stent placement: a multicenter retrospective analysis. Dis Esophagus 2019; 32:5393322. [PMID: 30888392 DOI: 10.1093/dote/doz012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 11/26/2018] [Accepted: 02/13/2019] [Indexed: 12/11/2022]
Abstract
Iodine-125 (125I) seed-loaded stent placement has served as an effective palliation for malignant esophageal strictures in China. We performed a retrospective study to identify the prognostic factors of this irradiation stent placement in advanced esophageal cancer patients. A total of 201 patients who underwent 125I seed-loaded stent placement were included in this study from June 2012 to March 2016 at five hospitals in China. The Cox regression models adjusted for stratification factors were used, and a stepwise multivariate analysis was performed to predict the overall survival and relief of dysphagia on the basis of pretreatment clinical characteristics, respectively. Three independent prognostic factors were identified for overall survival: histopathological subtype (squamous cell carcinoma vs. adenocarcinoma, hazard ratio [HR] 1.45, 95% confidence interval [CI95%]: 1.01-2.09, P = 0.046), serum total protein (≥66 g/L vs. <66 g/L, HR 0.61, CI95%: 0.48-0.59, P = 0.023), and performance status (<2 vs. ≥2, HR 1.57, CI95%: 1.09-2.08, P = 0.013). Four factors were significantly associated with the relief of dysphagia: T stage (T3 vs. T4, P = 0.003), tumor location (superior vs. inferior, P = 0.049), tumor-node-metastasis classification (IV vs. II, P = 0.025), and age (≥71 years vs. <71 years, P = 0.029). Prognostic factors identified from this analysis can be used to aid clinical decision-making and design future clinical trials.
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Affiliation(s)
- J Qin
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology
| | - H-D Zhu
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology
| | - J-H Guo
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology
| | - C-F Ni
- Department of Interventional Radiology, First Affiliated Hospital of Soochow University, Suzhou
| | - P Wu
- Department of Digestion, Xuzhou Central Hospital, The Affiliated Xuzhou Hospital of Southeast University
| | - H Xu
- Department of Interventional Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou
| | - A-W Mao
- Interventional Center, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Lu
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology
| | - C Su
- Clinical Research Institute, Zhongda Hospital, Medical School, Southeast University, Nanjing
| | - G-J Teng
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology
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Zhou C, Li H, Huang Q, Wang J, Gao K. Biliary self-expandable metallic stent combined with Iodine-125 seeds strand in the treatment of hilar malignant biliary obstruction. J Int Med Res 2019; 48:300060519887843. [PMID: 31884851 PMCID: PMC7783887 DOI: 10.1177/0300060519887843] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective To assess the safety and effectiveness of a self-expandable metallic stent
(SEMS) combined with Iodine-125 seeds strand to treat hilar malignant
biliary obstruction (MBO). Methods This retrospective study included patients who had received SEMS with
125I seeds strand (seeds group) or SEMS alone (controls) to
treat hilar MBO. Demographic, biochemical, stent patency, overall survival
and complications data were extracted and analysed. Results A total of 76 patients were included (seeds group, n = 40;
controls, n = 36), with a total of 608 seeds deployed in
the seeds group (mean, 15.2 ± 4.1 [range, 8–25] seeds per patient).
Statistically significant between-group differences were shown in median
stent patency time (seeds group, 387.0 ± 27.9 days [95% confidence interval
{CI} 332.4, 441.6] versus controls, 121.0 ± 9.1 days [95% CI 103.2, 138.8])
and in median overall survival (seeds group, 177.0 ± 17.9 days [95% CI
141.8, 212.2] versus controls, 123.0 ± 20.4 [95% CI 83.0, 163.0]). There
were no statistically significant between-group differences in complication
rates. Conclusion SEMS combined with 125I seeds strand is safe, feasible, and
tolerable in treating patients with hilar MBO, and may be effective in
prolonging stent patency time and overall survival.
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Affiliation(s)
- Chuanguo Zhou
- Department of Interventional Radiology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing, China
| | - Hui Li
- Department of Interventional Radiology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing, China
| | - Qiang Huang
- Department of Interventional Radiology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing, China
| | - Jianfeng Wang
- Department of Interventional Radiology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing, China
| | - Kun Gao
- Department of Interventional Radiology, Beijing Chaoyang Hospital, Affiliated Hospital of Capital Medical University, Beijing, China
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Zhou WZ, Fu YM, Yang ZQ, Shi HB, Liu S, Xia JG, Zhou CG. Study of Percutaneous Stent Placement with Iodine-125 Seed Strand for Malignant Biliary Obstruction. Cardiovasc Intervent Radiol. 2019;42:268-275. [PMID: 30506169 DOI: 10.1007/s00270-018-2117-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/08/2018] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate the effectiveness and safety of simultaneous placement of a self-expandable metallic stents (SEMS) and iodine-125 seed strand in the management of malignant obstructive jaundice (MOJ). MATERIALS AND METHODS This study included 132 patients with MOJ treated from November 2015 to October 2017. Forty-five patients underwent insertion of SEMS with iodine-125 seed strands (Seeds group); the remaining 87 patients underwent SEMS placement alone (Control group). Technical success was defined as accurate, successful deployment of SEMS with or without iodine-125 seed strand; clinical success was defined as 20% reduction in serum bilirubin within 1 week after the procedure, compared with baseline. Complications, duration of primary stent patency, and overall survival were evaluated. RESULTS Technical success was achieved in all patients in both groups. In the Seeds group, an average of 14 seeds (range 8-22) were implanted in the bile duct as a strand. Clinical success rates were similar between the groups (Seeds group, 93.3%; Control group, 95.4%). Major complications occurred in only one patient, in the Control group. The median period of primary stent patency was significantly longer in the Seeds group (194 days) than in the Control group (86 days; P = 0.049). The median overall survival was also significantly longer in the Seeds group (194 days) than in the Control group (96 days; P = 0.031). CONCLUSION SEMS combined with iodine-125 seed strands is effective and safe in the management of MOJ and can improve stent patency and patient survival.
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Li TK, Zhu GY, Li WM, Lu J, Wang C, Pan TF, Wang Y, Guo JH. [Implantation of the irradiation stent system intoportal vein: studies on normal beagles]. Zhonghua Yi Xue Za Zhi 2017; 97:2458-2462. [PMID: 28835050 DOI: 10.3760/cma.j.issn.0376-2491.2017.31.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To assess the feasibility and safety of the irradiation stent system in portal vein on normal beagles. Methods: A portal vein irradiation stent system was composed of an Iodine-125 seeds-carrier and a conventional stent.Twenty beagle dogs were randomly assigned to receive treatment with a conventional stent (5 beagle dogs) or an irradiation stent system (15 beagle dogs in three groups received 11.1, 22.2, 33.3 MBq radioactivity, n=5 in each dose group). Follow-up methods included blood biochemical test, color Doppler sonographyand CT scan at 0, 15, 30, 60, and 120 days after implantation of irradiation stent system.Pathological tissues were obtained from sacrificed beagle dogs on the 120th day. Results: The portal vein irradiation stent systems and the conventional stents were successfully deployed into the targeted portal vein segment in all beagles, none was dislodged during the deployment or the follow-up period.Differences of blood biochemical indexes and portal vein flow volume measured by color Doppler sonography were not significant (P>0.05). Stent systems were morphologically intact and patent.None of the peripheral organs had hemorrhage, necrosis or perforation.Pathological tissues revealed that the systems were surrounded by fibrous tissues and a few inflammatory cells, but with no significant differences in all groups. Conclusion: It indicates that portal veinirradiation stent system is safe in all dose groups, and it is feasible to design a special irradiation stent system for each patient according to the size of the portal vein tumor thrombus.
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Affiliation(s)
- T K Li
- Department of Interventional Radiology and Vascular Surgery, Zhongda Hospital, Southeast University, Nanjing 210009, China
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Zhang W, Luo J, Liu Q, Ma J, Qu X, Yang M, Yan Z, Wang J. Brachytherapy with Iodine-125 seeds strand for treatment of main portal vein tumor thrombi: an experimental study in a rabbit model. Am J Cancer Res 2016; 6:587-599. [PMID: 27152237 PMCID: PMC4851839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 12/07/2015] [Indexed: 06/05/2023] Open
Abstract
This study aims to establish an animal model of implanted main portal vein tumor thrombus (MPVTT) and to evaluate safety and efficacy of brachy therapy with Iodine-125 ((125)I) seeds strand to treat MPVTT of rabbit. VX2 tumor thrombus was implanted in main portal vein (MPV) of 32 New Zealand white rabbits. These rabbits were randomly divided into treatment group (Group T, T1-T16) and control group (Group C, C1-C16). (125)I seeds and blank seeds strand were implanted in MPV of rabbits in Group T and C, respectively. Changes of general condition, body weight and blood laboratory examination were monitored at every time point after procedure. 2 weeks later, 8 rabbits of each group were sacrificed for pathologic examination. The rest of rabbits were dissected postmortem, and therapeutic effects were evaluated on basis of multi-detector computed tomography and histopathology. Ki-67 labeling index (Ki-67 LI) and apoptosis index (AI) were compared between two groups. Overall survival period was recorded. At every time point after brachytherapy, more serious weight loss were detected in Group C. Results of liver function tests and blood cells counts showed no significant difference between two groups. Mean volume of tumor tissue within MPV were 565.40 ± 220.90 mm(3) in Group T and 2269.90 ± 437.00 mm(3) in Group C (P < 0.001). (Ki-67 LI) and AI were (4.14 ± 1.84)% and (6.51 ± 1.92)% in Group T, compared with (33.82 ± 6.07)% and (0.91 ± 0.26)% in Group C, respectively (P < 0.001). Media survival time of rabbits were 39.50 ± 2.37 days in Group T and 27.38 ± 1.22 days in Group C, respectively (P = 0.001). In conclusion, injecting and suspensory fixing VX2 tumor strip into MPV is a reliable method to establish MPVTT animal model. Brachytherapy with (125)I seeds strand was safe and effective to treat VX2 tumor strand inoculated in the MPV of rabbit.
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Affiliation(s)
- Wen Zhang
- Department of Interventional Radiology, Zhongshan Hospital, Fudan UniversityShanghai 200032, China
- Shanghai Institute of Medical ImagingShanghai 200041, China
| | - Jianjun Luo
- Department of Interventional Radiology, Zhongshan Hospital, Fudan UniversityShanghai 200032, China
| | - Qingxin Liu
- Department of Interventional Radiology, Zhongshan Hospital, Fudan UniversityShanghai 200032, China
| | - Jingqin Ma
- Department of Interventional Radiology, Zhongshan Hospital, Fudan UniversityShanghai 200032, China
| | - Xudong Qu
- Department of Interventional Radiology, Zhongshan Hospital, Fudan UniversityShanghai 200032, China
| | - Minjie Yang
- Department of Interventional Radiology, Zhongshan Hospital, Fudan UniversityShanghai 200032, China
| | - Zhiping Yan
- Department of Interventional Radiology, Zhongshan Hospital, Fudan UniversityShanghai 200032, China
| | - Jianhua Wang
- Department of Interventional Radiology, Zhongshan Hospital, Fudan UniversityShanghai 200032, China
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Niu L, Chen J, Yao F, Zhou L, Zhang C, Wen W, Bi X, Hu Y, Piao X, Jiang F. Percutaneous cryoablation for stage IV lung cancer: a retrospective analysis. Cryobiology. 2013;67:151-155. [PMID: 23806858 DOI: 10.1016/j.cryobiol.2013.06.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 06/13/2013] [Accepted: 06/13/2013] [Indexed: 12/25/2022]
Abstract
The aim of this study was to investigate the therapeutic effect of cryoablation treatment and palliative treatment in stage IV lung cancer. Fifty-four patients were enrolled into the study. Thirty-one patients received cryoablation treatment (including intra- and extrapulmonary tumors), and 23 patients had palliative treatment (no cryoablation). Both the safety of the procedure and overall survival (OS) for stage IV lung cancer were assessed during a 6.5 year follow-up period. The OS of patients in both groups and the effects of treatment timing and frequency were compared. The OS in the cryoablation group was significantly longer than in the palliative group (median OS: 14 months vs. 7 months, P = 0.0009). The OS of those who received delayed cryoablation treatment was longer than that observed for those who received timely treatment (median OS: 18.5 months vs. 10 months, P = 0.0485), but this was not observed in those who received palliative treatment (median OS: 7 months vs. 7.5 months, P = 0.9814). Multiple treatments played an important role in improving the OS of patients who received cryoablation treatment (median OS: 18 months vs. 14 months, P = 0.0376). There was a significant difference between cryoablation and palliative treatment, in terms of OS. In addition, multiple cryoablation treatments may have an advantage over single treatments.
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Chen JB, Li JL, He LH, Liu WQ, Yao F, Zeng JY, Zhang Y, Xu KQ, Niu LZ, Zuo JS, Xu KC. Radical treatment of stage IV pancreatic cancer by the combination of cryosurgery and iodine-125 seed implantation. World J Gastroenterol 2012; 18:7056-62. [PMID: 23323008 PMCID: PMC3531694 DOI: 10.3748/wjg.v18.i47.7056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 03/20/2012] [Accepted: 04/09/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the therapeutic effect of radical treatment and palliative treatment in stage IV pancreatic cancer patients.
METHODS: 81 patients were enrolled in the study. Radical treatment was performed on 51 patients, while 30 patients were put under palliative treatment. The procedural safety and interval survival for stage IV pancreatic cancer (IS-IV) was assessed by almost 2.5 years of follow-ups. The IS-IV of patients under the two kinds of treatment, and the effects of treatment timing and frequency on IS-IV, were compared.
RESULTS: The IS-IV of patients who received radical treatment was significantly longer than those who received palliative treatment (P < 0.001). The IS-IV of patients who received delayed radical or palliative treatment was longer than those who received accordingly timely treatment (P = 0.0034 and 0.0415, respectively). Multiple treatments can play an important role in improving the IS-IV of patients who received radical treatment (P = 0.0389), but not for those who received palliative treatment (P = 0.99).
CONCLUSION: The effect of radical treatment was significantly more obvious than that of palliative treatment, and multiple radical treatments may contribute more to patients than a single radical treatment.
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Chen Y, Luo KY, Li XG, Li YX, Zhang WF, Zhang ZP, Chu Y. Interstitial implantation of iodine-125 seeds induces apoptosis but inhibits cell proliferation in HCT-116-xenografted tumors in nude mice. Shijie Huaren Xiaohua Zazhi 2010; 18:2858-2862. [DOI: 10.11569/wcjd.v18.i27.2858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the effect of interstitial implantation of iodine-125 on the growth of adenocarcinoma of the large intestine and to explore potential mechanisms involved.
METHODS: Nude mice bearing HCT-116-xenografted tumors were randomly divided into two groups (n = 24 each): control group and experimental group. The control group underwent implantation of empty seeds, while the experiment group underwent implantation of iodine-125 seeds (14.8 MBq). On days 7, 14, 21 and 28 after implantation, mice were killed to calculate tumor growth, detect the expression of proliferating cell nuclear antigen (PCNA) in tumor tissue by immunohistochemistry, determine the apoptosis of tumor cells by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay, and observe the ultrastructural changes of tumor cells by transmission electron microscopy (TEM).
RESULTS: On days 7, 14, 21 and 28 after implantation, both tumor volume and weight were significantly lower in the experiment group than in the control group (tumor volume on day 28: 497.3 mm3 ± 7.8 mm3 vs 947.2 mm3 ± 40.4 mm3, P < 0.01; tumor weight on day 28: 1.131 g ± 0.079 g vs 2.139 g ± 0.094 g, P < 0.01). The reduced rate of tumor growth in the experimental group was higher than that in the control group (on day 28: 47.12% vs 25.77%). The expression of PCNA in the experiment group decreased with time and was significantly lower on day 28 than that in the control group. On day 14, apoptotic bodies began to appear and then gradually increased in number, reaching the peak on day 28.
CONCLUSION: Interstitial implantation of iodine-125 seeds induces apoptosis but inhibits cell proliferation in HCT-116-xenografted tumors in nude mice.
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Jin AQ, Huang XJ, Wang X, Fan H. Clinical application of self-expandable medical memorial metallic stent with iodine-125 seeds in treatment of esophageal carcinoma. Shijie Huaren Xiaohua Zazhi 2006; 14:814-818. [DOI: 10.11569/wcjd.v14.i8.814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To analyze the curative effect of self-expan-dable medical memorial metallic stent with iodine-125 seeds in the treatment of esophageal carcinoma at advanced stage.
METHODS: Forty-five patients with esophageal carcinoma at advanced stage were divided into group A and B. The patients in group A were treated with normal self-expandable stents, while those in group B received the stents with iodine-125 seeds. After the operation, the patients were followed up and their complications and survival time were analyzed.
RESULTS: The stents were successfully implanted in all the 45 patients. The patients were obviously relieved from their difficulties in swallowing. The survival time of patients in group A were 90-300 d, with an average of 171 ± 56 d, and those in group B were 120-450 d, with an average of 316 ± 116 d. There was significant difference between them (t = -3.385, P < 0.05).
CONCLUSION: Self-expandable stent with iodine-125 seeds can obviously alleviate the symptoms of difficulty in swallowing, improve the patients' life quality and survival time.
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