The Clinical Analysis Of Permanent Implantation Of Iodine-125 Radioactive Seeds For Osseous Metastases

Objectives A retrospective analysis was to evaluate the therapeutic efficacy of ¹²⁵I radioactive seed implant brachytherapy in patients with metastatic bone lesions.Methods In Chinese people’s Liberation Army 252 hospital, 32 patients with bone metastases were treated with ¹²⁵I radioactive seed implant brachytherapy from January 2011 to January 2014. These patients included 17 males and 15 females. The median age was 62 years（from 39⁷5 years）. All of the patients received drug analgesia or external irradiation, but the effect is poor or ineffective. 32 cases of patients with tumor derived respectively in 14 cases of lung cancer（including 11 cases of adenocarcinoma, 2 cases of squamous cell carcinoma, 1 cases of small cell carcinoma）, 6 cases of breast cancer, renal clear cell carcinoma in 4 cases, primary hepatocellular carcinoma in 2 cases, esophagus carcinoma in 2 cases, non Hodgkin’s lymphoma in 1 case, colorectal cancer in 1 case, bladder cancer in 1 case, ovarian cancer in 1 case. 32 cases of patients with metastatic cumulative number of 74. Primary tumors were confirmed by pathology, and bone metastases were diagnosed according to CT, MRI, ECT or bone tissue biopsy. Changes in the Visual Analog Scale（VAS）, and Karnofsky Score（KPS） were observed during the follow-up period. And the transfer tumor diameter of patients were recorded to assess changes in the local control rate. The data obtained were analyzed by statistical method.Results Preoperative and postoperative 1 day, 1 week and 2 months, the difference between the four groups VAS scores were statistically significant（c2=165.64, P=0.00）. The average onset time of the 66 metastatic lesions was 2.05 days（1⁷ days）, and the average duration of pain relief was 8.48 months（3¹2 months）. 66 metastatic lesions with different degrees of pain relief in 74 metastatic lesions. Preoperative and postoperative blood routine, liver and kidney function indexes were no statistical significance（WBC: F=1.37, P=0.28, RBC: F=1.56, P=0.23, Hb: F=0.85, P=0.44, PLT: F=0.01, P=0.98, AST: F=0.32, P=0.72, ALT: F=0.56, P=0.56, Cr: F=2.08, P=0.13, BUN: F=0.19, P=0.84）. Preoperative and postoperative serum alkaline phosphatase and serum calcium ion difference has statistical significance（F=412.85, P=0.00, F=35.56, P=0.00）. There was significant difference in the diameter of the tumor（t=10.19, P=0.00）. There were no bone marrow suppression, no liver injury, and renal injury in all patients. 11 cases of patients with a small amount of bleeding, 4 cases of postoperative patients with a transient pain, 2 cases of patients with mild fever symptoms, symptomatic treatment to ease after treatment. At 2 months, the difference of KPS scores were statistically significant（Z=﹣4.90, P=0.00）.Conclusions ¹²⁵I radioactive seed brachytherapy is a treatment with rapid onset, stable and lasting of pain relief. It has a certain effect on control and mitigation of local lesions. It has low rate of complications for patients, and can improve the physical condition of the patients significantly. It is a good method of radiotherapy. In the future, it is expected to become a supplementary treatment of bone metastases.