[Short- and medium-term clinical effects of CT guided (125)I radioactive seeds implantation in treatment of recurrent/metastatic malignant pelvic tumors].

OBJECTIVE: To investigate the Short- and medium-term clinical effects of clinical value of CT guided radioactive seed (125)I implantation in treating recurrent/metastatic malignant pelvic tumors.

METHODS: 30 patients (10 males and 20 females, the age ranges from 31 to 85, median 55 years) with recurrent/metastatic malignant pelvic tumors after combined therapy such as surgery, chemotherapy and radiotherapy et al, were enrolled in this study. The total lesions were 32 and the max diameter of each lesion ranges from 3.0 cm to 12.2 cm, median 4.8 cm. Under CT guidance, the operations were performed under local anesthesia and (125)I seeds of 2.96 x 10(7) Bq were implanted into tumors at a distance of 0.5 cm according to TPS (Treatment Plan System), and the MPG (matched peripheral doses) was 100 - 160 Gy Observed the the local control rate, overall survival rate, pain reliefs and clinical complications after 2 - 40 months follow-up (median 28 months).

RESULTS: After 2 - 40 months follow-up (median 28 months), 10/32 obtained CR, 13/32 obtained PR, 5/32 NC and 4/32 PD. The clinical effective rate was 87.5% (CR + PR + SD > 2 months). 1- and 2-year Local control rate were 83.3% and 62.5%, and overall 1- and 2- and 3- year survival rate were 87.7%, 73.1% and 45.7%, respectively, the median survival time was 28 months. The rate of pain relief was 21/23 (91.3%). Complications in the long term were Grade I - II radioactive rectum proctitis observed in 3 cases, Grade I radioactive cystitis observed in 1 case, insensible feeling in lower limb observed in 1 case for a long time. No other severe complications such as menorrhoea, acute pulmonary embolism, abscess, intestinal fistula, intestinal perforation, sinus tract were encountered in all patients.

CONCLUSION: CT guided radioactive seed (125)I implantation procedure can be a simple, safe and effective method in treating recurrent/metastatic malignant pelvic tumors, which can ease the pain of patients and improve the qualities of patients' lives and obtain good clinical effects with minimal damage and few complications.