¹²⁵I Radioactive Seed Implantation In Treating Peritoneal Metastatic Cancer

ObjectiveThe study is to investigate the clinical efficacy and safety of125Iradioactive seed implantation in treating peritoneal metastatic cancerguided by ultrasound.MethodsA total of32patients in this study，all from the China-Japan UnionHospital of Jilin University Since September2012to December2013.All the patients have undergone a rigorous screening.There are17casesof abdominal lymph node metastasis(including retroperitoneal lymphnode metastasis in8patients)，15patients with metastatic liver cancer；20males and12females, Among the32patients, the ages is between39to75years old, and the median age is63.5years old. Primary tumor forseven cases of gastric cancer, pancreatic cancer eight cases, nine cases ofcolorectal cancer, kidney cancer two cases, four cases of breast cancer,ovarian carcinoma one case, thymoma one case; the lymph nodediameter is1.7~5.3cm, the average is3.6cm. Liver metastases size is1.7-5.3cm, the average diameter is4.5cm(for multiple lesions, thesummation of lesion diameters are as a numerical variable). All caseswere examined by CT, MRI examination or biopsy pathology.Retrospective analysis of clinical symptoms, relieve pain observation,local tumor control situation, and its complications. ResultAfter a month’s treatment, the patients of this group withpreoperative mild pain in14patients had complete remission ofsymptoms; in12cases of moderate pain before surgery, there were8cases of complete remission and4cases of partial remission; in6casesof severe pain in patients with preoperative,there were two cases ofcomplete remission, partial remission in three cases, and one case hadno remission. CR+PR31cases,the total efficiency is96.8%.After theimplantation in this group,27patients were treated with postoperativechemotherapy, there were4patients can not tolerate chemotherapy, and1case did not give chemotherapy. All patients underwent CT scan3months later,the conclusion is:CR3cases, PR18cases, NC9cases, PD2cases; There were21effective cases, and the efficiency is65.6%.6months later,the conclusion is: CR5cases，PR19cases，NC5cases，PD3cases；There were24effective cases, and the efficiency is75.0%. Onepatient who intra-operative puncture site bleeding,did not continuebleeding,after given suymptomatic treatment. There were7patients withtolerated postoperative puncture-site pain,2patients with varyingdegrees particle displacement.This group didn’t show up radiationenteritis, intestinal fistula, infection and other complications. All patientswere followed for up to20months, the shortest in April. The mediansurvival time is7months. So far two patients are still alive, five cases ofmetastatic recurrented in the original place, two cases in chest wall,brain, six cases in liver, spleen, lung, three cases in pulmonary, and twocases occured extensive abdominal metastasis.11cases of death due totumor progression.1patient died of heart disease.1-year survival ratewas68.9%. Inclusion125I radioactive seed implantation in the treatment of peritonealmetastases can not only control tmor growth in the short term and thelocal tumor results clearly, but also mitigate different degrees of pain.Shorter postoperative hospital stay, faster recovery, safer surgeryoperation, minimally invasive, fewer complications, higher quality oflife of patients are the advantages.