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An analysis of brachytherapy with computed tomography-guided permanent implantation of Iodine-125 seeds for recurrent nonkeratin nasopharyngeal carcinoma

Authors Shen X, Li Y, Zhang Y, Kong J, Li Y

Received 19 February 2015

Accepted for publication 18 March 2015

Published 2 May 2015 Volume 2015:8 Pages 991—997


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Daniele Santini

Xinying Shen,1,2 Yong Li,2 Yanfang Zhang,2 Jian Kong,2 Yanhao Li1

1Department of Interventional Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 2Department of Interventional Radiology, Shenzhen People’s Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, People’s Republic of China

Background: 125I seed implantation is a new method in treatment of nasopharyngeal carcinoma (NPC), and it is worthwhile to evaluate its feasibility. In this study, we performed brachytherapy with computed tomography (CT)-guided permanent implantation of 125I seeds in the treatment of patients with the recurrence of NPC.
Methods: A total 30 patients (20 male and ten female) at the median age of 55 (range 25–80) years were diagnosed with recurrent nonkeratin NPC, with a total 38 lesions and a short disease-free interval (median ~11 months) after primary radiotherapy alone or combined with chemotherapy. Patients received CT scan, starting from 2 months after the treatment. Follow-up was conducted for ~2–38 months to observe the local control rate and overall survival rate. We also analyzed the possible correlation between survival periods and the status of recurrent tumors.
Results: The local control rates at 6, 12, 24, 30, and 36 months after the procedure of 125I seed implantation were 86.8%, 73.7%, 26.3%, 15.8%, and 5.3%, respectively. The overall 1-, 2-, and 3-year survival rates were 80.0% (24/30), 30.0% (9/30), and 6.7% (2/30), respectively, with a median survival period of 18 months (17.6±8.6 months). Interestingly, the survival periods of the patients who had primary radiotherapy with or without chemotherapy were 15.8±7.9 and 24.3±7.9 months, respectively. Kaplan–Meier survival analysis demonstrated that χ2 (log rank) was 7.555, with very significant difference (P<0.01). The survival periods of patients in tumor stages I, II, III, and IV were 25.4±8.7, 19.8±9.4, 16.1±4.5, and 12.8±7.8 months, respectively, with significant differences (P<0.05).
Conclusion: Our data suggest that the survival period of recurrent NPC patients after 125I seed implantation is inversely related to the tumor stages of the recurrence but not to chemotherapy after the primary radiotherapy. Therefore, CT-guided 125I seed implantation can be set for treatment of recurrent NPC, for better survival rate with minimal damage.

Keywords: CT-guided 125I seed, radiochemotherapy, NPC

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