Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

CT-guided 125I brachytherapy combined with chemotherapy for the treatment of unresectable or locally advanced pancreatic carcinoma

1.

Department of Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

Diagn Interv Radiol 2020; 1: -
Read: 103 Published: 10 March 2020

PURPOSE: To explore the feasibility and clinical effectiveness of percutaneous CT-guided iodine-125 brachytherapy (125I brachytherapy) combined with chemotherapy for the treatment of patients with unresectable or locally advanced pancreatic carcinoma (PC).

METHODS: We retrospectively reviewed 66 patients with Stage III and IV PC who had received chemotherapy. A total of 35(53.03%) patients receiving 125I brachytherapy and chemotherapy (gemcitabine + cisplatin, GP) were classified as Group A, and 31(46.97%) patients who received GP chemotherapy alone were categorized as Group B. The evaluated indications were local control rate (LCR), local progression-free survival (LPFS), overall survival (OS), treatment-related complications, and the degree of symptom relief. Kaplan-Meier curves, log-rank test and Cox regression models were generated and used for further analysis to identify predictors of outcomes.

RESULTS: The median follow-up time was 6.00 ± 0.84 months. The 1-, 3-, 6-, 12- and 18-month LCRs for Group A were 35/35(100.00%), 25/28(89.29%), 15/21(71.43%), 3/8(37.50%) and 1/3(33.33%), respectively; and those for Group B were 27/31(87.10%), 16/23(69.57%), 7/17(41.18%), 1/7(14.29%) and 0/3(0.00%), respectively. The LCR differed at 1-, 3- and 6-months (P = 0.032; P = 0.009; P = 0.030; respectively). The median LPFS was 7.00 ± 0.30 months and 5.00 ± 0.75 months for Group A and B (P = 0.023), respectively; however, the median OS in both groups was not significantly different (8.00±0.77 months vs. 6.00±1.04 months. P = 0.917). No life-threatening complications occurred during or after the procedures. Patients in Group A experienced better pain control and relief of abdominal distension than those in Group B.

CONCLUSION: CT-guided 125I brachytherapy is a feasible, safe, and valuable treatment for patients with unresectable PC.

EISSN 1305-3612