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The safety and efficacy of interstitial 125I seed implantation brachytherapy for metastatic epidural spinal cord compression
Jian Lu1, Wei Huang2, Zhongmin Wang3, Ju Gong1, Xiaoyi Ding2, Zhijin Chen1, Ning Xia1, Nannan Yang1, Zhiyuan Wu2, Chen Wang4, Jun Chen4
1 Department of Radiology, Ruijin Hospital Luwan Branch, Shanghai 200020, China
2 Department of Interventional Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200020, China
3 Department of Interventional Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200020; Department of Interventional Radiology, The Third Affiliated Hospital of the Medical College of Shihezi University, Xinjiang, 832008, China
4 Department of Interventional Radiology, The Third Affiliated Hospital of the Medical College of Shihezi University, Xinjiang, 832008, China
Correspondence Address:
Zhongmin Wang
Department of Interventional Radiology, The Third Affiliated Hospital of the Medical College of Shihezi University, Xinjiang 832008; Department of Interventional Radiology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai 200020
China
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jcrt.JCRT_938_17
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Objective: The objective of this study is to investigate the safety and efficacy of 125I seed interstitial implantation brachytherapy for metastatic epidural spinal cord compression (MESCC) as well as the life quality of patients.
Materials and Methods: From April 2009 to May 2015, 28 patients who met the eligibility criteria were retrospectively reviewed. The number of implanted 125I seeds ranged from 7 to 62, with appropriate activity of 0.5–0.8 mCi. The postplan showed that the matched peripheral dose (MPD) of tumors was 80–140 Gy. The duration of follow-up ranged from 1 to 32 months with a median of 18 months. Visual analog scale (VAS), Karnofsky Performance Scale (KPS), and motor performance were evaluated before and after treatment.
Results: Seed implantation was well tolerated by all patients. Pain was obviously alleviated in all patients. VAS score of patients was significantly decreased from 4.89 ± 1.52 before treatment to 1.61 ± 1.20 after treatment, and KPS score was significantly increased from 73.93 ± 12.27 to 86.76 ± 10.90 (P < 0.05). The local control rates of 1, 2, and 3 years were 77%, 34%, and 14%, respectively, with a median of 19 months (7–32 months). The survival rates of 1, 2, and 3 years were 81%, 54%, and 14%, respectively, with a median of 25 months. Seven (100%) nonwalking patients regained motor ability. No myelopathy or other neurologic sequelae were encountered.
Conclusion: Interstitial 125I seed implantation brachytherapy may be a promising local therapy, which was an alternative and palliative way for treating MESCC.
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