Lobaplatin-TACE combined with radioactive 125I seed implantation for treatment of primary hepatocellular carcinoma.

AIM: To investigate the efficacy and safety of lobaplatin-transcatheter arterial chemoembolization (TACE) combined with radioactive 125I seed implantation in treatment of primary hepatocellular carcinoma (HCC). METHODS: 75 patients with primary HCC were enrolled in the study, among them 43 receiving lobaplatin- TACE (TACE group) and 32 lobaplatin-TACE combined with 125I seed implantation (TACE+125I group). After treatment, the local remission rates and postoperative complications of two groups were compared using the Pearson Chi-square test. Overall survival in the two groups was calculated using Kaplan-Meier survival curves and the differences were tested using Log-rank test. RESULTS: There were 7 cases of complete response (CR), 13 of partial response (PR), 6 of stable disease (SD) and 17 of progressive disease (PD) in the TACE group, with 13 cases of CR, 9 of PR, 5 of SD and 5 of PD in the TACE+125I group. The disease control rates of TACE and TACE+125I group were 60.5% (26/43) and 84.4% (27/32), respectively, with a significant difference between them (P < 0.05). The survival rates at 6, 12 and 18 months in the TACE group were 100.0%, 81.8% and 50.0%, respectively, and those in TACE+125I group were 100.0%, 93.8% and 65.6%. The mean survival times in the TACE and TACE+125I groups were 19.5 and 22.9 months, respectively. There was a significant difference in the overall survival rate between two groups (P < 0.05). No serious complications were encountered in either group. CONCLUSION: Lobaplatin-TACE combined with 125I seed implantation is favorable and safe for treatment of primary HCC.

Experimental research on a novel iodine-125 seed strand connected using magnesium alloy AZ31.

BACKGROUND AND PURPOSE: Aim of this research is to study the in vivo degradation and biocompatibility in rabbits and the dose distribution of novel iodine-125 seed strands connected using magnesium alloy AZ31. METHOD: Thirty-three New Zealand rabbits were divided into three Groups (A, B, and C). All rabbits in Groups A and C were implanted with VX2 tumors. For Group A, radioactive iodine-125 seed strands were implanted into the VX2 tumors. For Group B, non-radioactive iodine-125 seed strands were implanted into thigh muscle. Rabbits in Group C were used as controls. Displacement of the seed strands was assessed using X-ray and CT. Blood and urine samples were collected from all groups to measure changes in magnesium ion concentrations. The changing effect of alloy AZ31 tube according to dose distribution of iodine-125 was evaluated using the Monte Carlo method. RESULTS: In Groups A and B, 14 days after implantation, majority of the magnesium alloy tubes were fragmented, and 28 days after implantation, the magnesium alloy tubes were completely degraded. Small differences in dose distribution were observed between bare iodine-125 seeds and iodine-125 seed strands. CONCLUSIONS: Our results suggest that these novel iodine-125 seed strands connected using magnesium alloy AZ31 are promising anti-cancer drug for brachytherapy due to the rapid degradation of connective materials and even distribution of seed doses in tumors. Some recent patents are also outlined in this article.

[125Iodine-induced radiation damage in the femoral arteries of rabbits].

BACKGROUND & OBJECTIVE: What damages 125Iodine (125I) seed implantation will do to normal tissue is an observation topic in clinic. This study was to investigate the impact of 125I seed implantation to the femoral arteries of rabbits. METHODS: A total of 30 healthy rabbits were divided into 3 groups. The femoral sheath in the hind leg at one side selected by random was opened and 10 125I seeds at 0.79-0.85 mCi were implanted near the femoral artery according to the treatment planning system (TPS) before operation. In control group, 10 seeds without radioactivity were implanted. After 2 weeks, 2 months and 4 months, the rabbits were killed, the vessel wall nearest to the seeds was taken out and its morphologic changes were observed by gross examination, light microscopy and electron microscopy. RESULTS: In gross observation, the vessel segments of the legs with 125I seed implantation had no apparent abnormality. Under light microscope, a few exfoliative endothelial cells were observed. Under electron microscope, exfoliation of endothelial cells, degeneration of endothelial cells and smooth muscle cells were observed. The ratios of degenerative vessel endothelial cells to all vessel endothelial cells were 60%-70% in 2-week group, 50% in 2-month group and 30% in 4-month group; the ratios of degenerative vessel smooth muscle cells to all vessel smooth muscle cells in the 3 groups were 50%, 30% and 10%. CONCLUSION: 125I permanent implantation at 0.79-0.85 mCi mainly damages endothelial cells and smooth muscle cells of the normal vessels and this damnification is reversible.

[Radioactive seed 125I implantation in treating recurrence and metastasis after liver transplantation in hepatoma].

OBJECTIVE: To investigate the clinical value of CT-guided radioactive seed (125)I implantation in treating recurrence and metastasis after liver transplantation in hepatoma. METHODS: Eleven patients with recurrence and metastasis after liver transplantation for hepatoma, with 45 metastatic lesions, 2.5 cm in diameter on average totally 9 males and 2 females, aged 56 (35 approximately 68), underwent CT-guided radioactive seed 125I implantation for 33 man-times. 125I seeds of the radioactivity of 30 MBq at a distance of 0.5 approximately 1.0 cm were implanted into the recurrence and metastasis lesions according to TPS system before the operation. The matched peripheral dosage (MPD) was 100 approximately 150 Gy, and the number of radioactive seeds for one patient ranged 10 approximately 100. RESULTS: Among the 45 lesions, 17 obtained CR, 20 PR, 7 NC, and 1 PD. The response rate was 82.2%. Side effects occurred during the procedure including pneumothorax in 1 cases with the lung compressed less than 30 percent, bleeding in 3 cases, and blood in sputum and defervescence in 5 cases. Seeds migration 2 months after the operation occurred in 2 cases. WBC decreased slightly in 2 cases 2 weeks after the operation, with the WBC count >or= 3 x 10(9)/L. No other severe complications, such as massive hemorrhage, bile fistulae, and pancreatic fistula were seen. CONCLUSION: CT guided radioactive seed 125I implantation procedure has good clinical effects with minimal damage and few complications in treating recurrence and metastasis after liver transplantation in hepatoma.

[CT guided radioactive seed 125I implantation in treatment of pancreatic cancer].

OBJECTIVE: To investigate the clinical value of CT guided radioactive seed (125)I implantation in treatment of pancreatic cancer. METHODS: Twenty-six patients with pancreatic cancer 6.1 cm in size on average, 21 males and 5 females, aged 60 +/- 13 (47 - 73), underwent CT guided radioactive seed (125)I implantation. Of the 26 patients 15 had the symptom of severer abdominal pain and 10 had jaundice. Three of them were in the TNM (pTNM) stage II, 30 in the stage III, and 3 in the stage IV. Treatment plan system was used to design the distribution of the seed (125)I needed. Under CT guidance, the (125)I seeds of (2.2 - 3.3) Mq were implanted into the pancreatic cancer at a distance of 1.0 - 1.5 cm. A follow-up for 3 - 12 months was conducted. RESULTS: Complete relief (CR) of the symptoms was seen in 9 patients, partial relief (PR) in 2 patients, and no change (NC) in 4 cases with an effective rate of 73.4%. The abdominal pain was relieved 3 - 7 days after the implantation. CT performed 2 months after implantation showed CR in 2 cases, PR in 13 cases, NC in 5 cases, and progression in 5 cases with an overall effective rate of 57.7%. Four patients died of local progression and 2 patients died of distant metastasis. Migration of the seeds into the liver was seen in 3 patients and slight decrease of white blood cells was seen in 1 patient during the 2-month follow-up. No severe complications, such as pancreatic leakage, acute pancreatitis, intestinal hemorrhage, etc, were found. CONCLUSION: Safe and with minimal damage and few complications, CT guided radioactive seed (125)I implantation is effective in treatment of pancreatic cancer.