Herein,we report a new technique that consists of placing two 125 I seed strands and two stents in the right and left intrahepatic bile ducts for the treatment of hilar cholangiocarcinoma.A 75-year-old man presented w...Herein,we report a new technique that consists of placing two 125 I seed strands and two stents in the right and left intrahepatic bile ducts for the treatment of hilar cholangiocarcinoma.A 75-year-old man presented with jaundice and was diagnosed with Bismuth type Ⅳ Klatskin tumor.Abdominal computed tomography(CT) showed intrahepatic and extrahepatic bile ductdilatation and a soft tissue mass in the hepatic hilum.Because curative surgical resection was not possible,we placed 125 I seed strands and stents in the right and left intrahepatic bile ducts.Three months later,abdominal CT showed less intrahepatic and extrahepatic bile duct dilatation than before the procedure.This technique was feasible and could be considered for the treatment of patients with Bismuth type Ⅳ tumors.展开更多
Excessive radiation exposure may lead to edema of the spinal cord and deterioration of the nervous system. Magnetic resonance imaging can be used to judge and assess the extent of edema and to evaluate pathological ch...Excessive radiation exposure may lead to edema of the spinal cord and deterioration of the nervous system. Magnetic resonance imaging can be used to judge and assess the extent of edema and to evaluate pathological changes and thus may be used for the evaluation of spinal cord injuries caused by radiation therapy. Radioactive ^125I seeds to irradiate 90% of the spinal cord tissue at doses of 40–100 Gy （D90） were implanted in rabbits at T10 to induce radiation injury, and we evaluated their safety for use in the spinal cord. Diffusion tensor imaging showed that with increased D90, the apparent diffusion coefficient and fractional anisotropy values were increased. Moreover, pathological damage of neurons and microvessels in the gray matter and white matter was aggravated. At 2 months after implantation, obvious pathological injury was visible in the spinal cords of each group. Magnetic resonance diffusion tensor imaging revealed the radiation injury to the spinal cord, and we quantified the degree of spinal cord injury through apparent diffusion coefficient and fractional anisotropy.展开更多
AIM:To evaluate the survival outcomes of patients with lacrimal gland adenoid cystic carcinoma who underwent eye-sparing surgery combined with ^(125I)seed implantation radiotherapy or local externalγ-ray radiotherapy...AIM:To evaluate the survival outcomes of patients with lacrimal gland adenoid cystic carcinoma who underwent eye-sparing surgery combined with ^(125I)seed implantation radiotherapy or local externalγ-ray radiotherapy.METHODS:In this retrospective comparative case series,the clinical records of 27 primary and 8 recurrent patients were reviewed.Univariate and multivariate analyses were used to identify risk factors associated with distant metastasis(DM),and the overall survival(OS)after the initial surgery was analyzed.RESULTS:The median follow-up after radiotherapy was 36 mo(range 6-120 mo).At the last follow-up after radiotherapy,26(74.3%)patients had no evidence of disease,7(20%)patients had DM,2(5.9%)patients died of DM,and 1 patient with DM was lost to follow-up.Univariate analyses showed that duration of symptoms,bone destruction,T stage classification,and wide excision surgery were risk factors influencing DM(P<0.05).The 5-year and 10-year OS rates after the initial surgery were 95.8%and 79.9%,respectively.The 5-year DM-free survival and disease-free survival rates after radiotherapy were 66.4%and 52.7%,respectively.CONCLUSION:^(125I)seed radiotherapy and local externalγ-ray radiotherapy may have similar therapeutic effects in preventing DM.Patients with T1/T2 stage disease have a better prognosis than those with T3/T4 stage disease.展开更多
Hepatocellular carcinoma （HCC） is an aggressive malignancy. Early lesions respond well to hepatic resection or liver transplantation. However, only a few of HCC patients are suitable for surgical intervention. Exter...Hepatocellular carcinoma （HCC） is an aggressive malignancy. Early lesions respond well to hepatic resection or liver transplantation. However, only a few of HCC patients are suitable for surgical intervention. External beam radiation and chemotherapy is poorly efficacious. In the last 20 years, HCCs belonging to the radiosensitive tumor group has been confirmed. Along with the development of new radiotherapy technology and facilities, the research about brachytherapy（especially ^125I seed implantation therapy） has provoked more interests in the world. Radioactive seed implantation therapy is a form of interstitial brachytherapy, with the property of local ＂conformal radiotherapy＂ and the advantages of minimal invasion, convenience, high performance, and minimal adverse effects. It is a promising therapy for HCC, however the dosimetry hasn＇ t yet been identified and lacks verification in prospective research. This report aims to further explore the best prescription dose and radioactivity for ^125I interstitial implantation brachytherapy for HCC.展开更多
Objective The aim of this study was to investigate the relationship between miR-7-5p expression and intertissue-^(125)I irradiation sensitivity in pancreatic cancer tissues and to analyze the function of target genes....Objective The aim of this study was to investigate the relationship between miR-7-5p expression and intertissue-^(125)I irradiation sensitivity in pancreatic cancer tissues and to analyze the function of target genes.Methods Thirty-seven patients with unresectable pancreatic ductal adenocarcinoma(PDAC)treated with radioactive ^(125)I seed implantation were enrolled.RT-PCR was used to detect the expression level of miR-7-5p in cancer tissues and analyze the relationship between miR-7-5p expression and ^(125)I radiation sensitivity.Bioinformatic software and online tools were used to predict the miR-7-5p target genes and analyze their functional annotation and pathway enrichment.Results Radioactive ^(125)I seed implantation was followed up for 2 months.The objective response rate of the miR-7-5p high expression group was 65.0%(13/20),whereas the objective response rate of the miR-7-5p low expression group was 5.88%(1/17),and the difference between the two groups was statistically significant(χ^(2)=13.654,P<0.001).A total of 187 target genes were predicted using three databases.GO functional annotation showed that target genes were mainly involved in cellular response to insulin stimulus,regulation of gene expression by genetic imprinting,cytosol,peptidyl-serine phosphorylation,bHLH transcription factor binding,cargo loading into vesicles,cellular response to epinephrine stimulus,and nucleoplasm.KEGG pathway enrichment analysis showed that target genes were mainly involved in the ErbB signaling pathway,HIF-1 signaling pathway,axon guidance,longevity regulatory pathway,endocrine resistance,glioma,choline metabolism in cancer,and EGFR tyrosine kinase inhibitor drug resistance.Molecular complex detection analysis by Cytoscape revealed that PIGH,RAF1,EGFR,NXT2,PIK3CD,PIK3R3,ERBB4,TRMT13,and C5orf22 were the key modules of miR-7-5p target gene clustering.Conclusion The expression of miR-7-5p in pancreatic cancer tissues positively correlated with the radiosensitivity of ^(125)I seeds.Via targeted gene regulation,miR-7-5p acts on the network of multiple signaling pathways in PDAC and participates in its occurrence and development.Thus,miR-7-5p may become a predictive index of ^(125)I seed implantation therapy sensitivity in PDAC patients.展开更多
This case report describes a patient with advanced gallbladder cancer who developed septic shock associated with iodine-125(^(125)I)seed implantation.The treatment process is described to provide a clinical reference ...This case report describes a patient with advanced gallbladder cancer who developed septic shock associated with iodine-125(^(125)I)seed implantation.The treatment process is described to provide a clinical reference for similar cases.A 52-year-old woman with recurrence of advanced gallbladder cancer underwent ^(125)I seed implantation and developed postoperative sepsis with septic shock.The blood culture suggested infection with Aeromonas caviae and Enterococcus faecalis.Vancomycin and imipenem were immediately administered according to the drug sensitivity results,along with immunoglobulin therapy and vasoactive drugs.The patient’s condition gradually stabilized after comprehensive treatment.Sepsis with septic shock is a rare but potentially fatal complication of ^(125)I seed implantation.Timely administration of broad-spectrum antibiotics,immunoglobulin therapy,and vasoactive drugs is very important to stabilize the patient’s condition.Our treatment of this patient can serve as a reference for clinicians to manage this complication in similar cases.展开更多
Cancer is a leading cause of death worldwide. In 2030, 26.4 million new cases will be diagnosed, with 17 million deaths accounted worldwide. Prostate cancer is the sixth most common type in the world, and the second m...Cancer is a leading cause of death worldwide. In 2030, 26.4 million new cases will be diagnosed, with 17 million deaths accounted worldwide. Prostate cancer is the sixth most common type in the world, and the second most commom in men. For Brazil, the number of new cases of prostate cancer in 2010 is estimated to 52,350. Treatment of prostate cancer may be by surgery, radiation or even vigilant observation. A method of radiotherapy which has been extensively used is brachytherapy, where Iodine-125 seeds are placed inside or next to the area requiring treatment. Iodine seeds can be introduced loose seeds or stranded in bioabsorbable polymers in order to increase the dosimetric coverage of the prostate and reducing the chance of seed migration. Data were gathered concerning the commercialization of loose seeds and stranded seeds, between 2005 and 2011, in Brazil. It was noted that the number of stranded seeds commercialized in Brazil (around 80%) has always been much greater than the number of loose seeds, reaching 90% last year. The main reason is the reduction of the seed migration events into other parts of the body, since there is a potential hazard even considering that no harmful effect has been observe. The data regarding dosimetry are still controversial, since the seeds that migrate is normally no more than 1%.展开更多
Background This study evaluated the clinical application of CT guided ^125iodine implantation in patients with portal vein tumor thrombus in primary hepatocellular carcinoma. Methods The ten patients （9 males and 1 f...Background This study evaluated the clinical application of CT guided ^125iodine implantation in patients with portal vein tumor thrombus in primary hepatocellular carcinoma. Methods The ten patients （9 males and 1 female, aged from 36 to 72 years） with portal vein tumor thrombus accompanying hepatocellular carcinoma had been treated with comprehensive therapy including surgery, transcatheter arterial chemoembolization, radiotherapy ablation, microwave ablation or percutaneous ethanol injection. The average diameter of each tumor thrombus was 21.5 mm × 30.5 mm. Seeds of 30 MBq ^125I were implanted 5 mm apart within the portal vein tumor thrombus. The follow-up after 4 months included enhanced spiral CT. Results CT screening of the tumours indicated that 4 out of 10 patients showed complete response to the therapy, 5 partial response and 1 stable disease. Adverse effects included aggravated abdominal dropsy and temporarily increased transaminase, which were controlled by medical management. Severe complications such as haemorrhage, biliary fistula hepatic abscess, pancreatic fistula and hepatic function failure were not observed. Implanted seeds migrated to lung and left hepatic lobe in 1 case. Conclusion CT guided implantation of ^125iodine seeds, can effectively treat portal vein tumor thrombus accompanying hepatocellular carcinoma with minimal damage and few complications.展开更多
Objective:To investigate patient-specific radioprotection mathods for people in close contact with cancer patientstreated by 12I-seed implantation.Methods:The initial dose rates(D_(0))at distances of 30 and 100 cm fro...Objective:To investigate patient-specific radioprotection mathods for people in close contact with cancer patientstreated by 12I-seed implantation.Methods:The initial dose rates(D_(0))at distances of 30 and 100 cm from 80 patients who had undergone ^(125)I-seed implantation were measured within 24 h of the procedure.The dose rate at t(D_(t))and effective dose(E)were calculated according to the measurad vales of D.The appropriate precaution times for general adult family members,spouses,coworkers,and children or pregnant women were determined,and the relationships between and precaution time for different close-contact groups were derived by curve-fitting the corresponding data.Results:The mean D vahes of 80 patients at distanes of 30 and 100cm were(15.24±11.25)μSv/h and(1.96±2.63)μSv/h,respectively(P<0.05).The mean values and range of precaution time for general adult familymembers,spouses,coworkers,and children or pregnant women were(4.17±16.55),(102.93±49.22),(51.00±61.29),and(34.27±56.90)d(0-90.61),(0-234.01),(0-247.81),and(0-224.69)d,respectively.Furthemore,a logarithmic relationship betwen D and precaution time(Y)was observed for the different groujps.The equations of these relationships were detemined to be Y=-131.569+83.256 lnD_(0) for general adult family mambers,Y=—108.532+83.318 lnD_(0) for spouses,Y=25.470+83.318 lnD,for coworkers,and Y=2.585+83.229 lnD_(0) for children or pregnant women.Conchusions:Some cancer patients treated by ^(125)I-seed brachytherapy emitover-dose levels of γ-rays,necessitatingradiation protection for their close contacts.However,appropriate patient-specific radiation protection fordifferent close contacts can be determined based on the precaution time calculated using the D_(0) value.展开更多
基金Supported by Peak of Six Personnel in Jiangsu Province,No.2013-WSN-038
文摘Herein,we report a new technique that consists of placing two 125 I seed strands and two stents in the right and left intrahepatic bile ducts for the treatment of hilar cholangiocarcinoma.A 75-year-old man presented with jaundice and was diagnosed with Bismuth type Ⅳ Klatskin tumor.Abdominal computed tomography(CT) showed intrahepatic and extrahepatic bile ductdilatation and a soft tissue mass in the hepatic hilum.Because curative surgical resection was not possible,we placed 125 I seed strands and stents in the right and left intrahepatic bile ducts.Three months later,abdominal CT showed less intrahepatic and extrahepatic bile duct dilatation than before the procedure.This technique was feasible and could be considered for the treatment of patients with Bismuth type Ⅳ tumors.
基金supported by the Science and Technology Development Project Funds of Science and Technology Department of Jilin Province in China,No.20120724
文摘Excessive radiation exposure may lead to edema of the spinal cord and deterioration of the nervous system. Magnetic resonance imaging can be used to judge and assess the extent of edema and to evaluate pathological changes and thus may be used for the evaluation of spinal cord injuries caused by radiation therapy. Radioactive ^125I seeds to irradiate 90% of the spinal cord tissue at doses of 40–100 Gy （D90） were implanted in rabbits at T10 to induce radiation injury, and we evaluated their safety for use in the spinal cord. Diffusion tensor imaging showed that with increased D90, the apparent diffusion coefficient and fractional anisotropy values were increased. Moreover, pathological damage of neurons and microvessels in the gray matter and white matter was aggravated. At 2 months after implantation, obvious pathological injury was visible in the spinal cords of each group. Magnetic resonance diffusion tensor imaging revealed the radiation injury to the spinal cord, and we quantified the degree of spinal cord injury through apparent diffusion coefficient and fractional anisotropy.
基金Supported by Beijing Hospitals Authority,Ascent Plan(No.DFL20190201).
文摘AIM:To evaluate the survival outcomes of patients with lacrimal gland adenoid cystic carcinoma who underwent eye-sparing surgery combined with ^(125I)seed implantation radiotherapy or local externalγ-ray radiotherapy.METHODS:In this retrospective comparative case series,the clinical records of 27 primary and 8 recurrent patients were reviewed.Univariate and multivariate analyses were used to identify risk factors associated with distant metastasis(DM),and the overall survival(OS)after the initial surgery was analyzed.RESULTS:The median follow-up after radiotherapy was 36 mo(range 6-120 mo).At the last follow-up after radiotherapy,26(74.3%)patients had no evidence of disease,7(20%)patients had DM,2(5.9%)patients died of DM,and 1 patient with DM was lost to follow-up.Univariate analyses showed that duration of symptoms,bone destruction,T stage classification,and wide excision surgery were risk factors influencing DM(P<0.05).The 5-year and 10-year OS rates after the initial surgery were 95.8%and 79.9%,respectively.The 5-year DM-free survival and disease-free survival rates after radiotherapy were 66.4%and 52.7%,respectively.CONCLUSION:^(125I)seed radiotherapy and local externalγ-ray radiotherapy may have similar therapeutic effects in preventing DM.Patients with T1/T2 stage disease have a better prognosis than those with T3/T4 stage disease.
文摘Hepatocellular carcinoma （HCC） is an aggressive malignancy. Early lesions respond well to hepatic resection or liver transplantation. However, only a few of HCC patients are suitable for surgical intervention. External beam radiation and chemotherapy is poorly efficacious. In the last 20 years, HCCs belonging to the radiosensitive tumor group has been confirmed. Along with the development of new radiotherapy technology and facilities, the research about brachytherapy（especially ^125I seed implantation therapy） has provoked more interests in the world. Radioactive seed implantation therapy is a form of interstitial brachytherapy, with the property of local ＂conformal radiotherapy＂ and the advantages of minimal invasion, convenience, high performance, and minimal adverse effects. It is a promising therapy for HCC, however the dosimetry hasn＇ t yet been identified and lacks verification in prospective research. This report aims to further explore the best prescription dose and radioactivity for ^125I interstitial implantation brachytherapy for HCC.
基金Supported by grants from the health commission of Hubei Province scientific research project(No.WJ2019H510)the Natural Science Foundation of Inner Mongolia Autonomous Region(No.2021MS8071),China.
文摘Objective The aim of this study was to investigate the relationship between miR-7-5p expression and intertissue-^(125)I irradiation sensitivity in pancreatic cancer tissues and to analyze the function of target genes.Methods Thirty-seven patients with unresectable pancreatic ductal adenocarcinoma(PDAC)treated with radioactive ^(125)I seed implantation were enrolled.RT-PCR was used to detect the expression level of miR-7-5p in cancer tissues and analyze the relationship between miR-7-5p expression and ^(125)I radiation sensitivity.Bioinformatic software and online tools were used to predict the miR-7-5p target genes and analyze their functional annotation and pathway enrichment.Results Radioactive ^(125)I seed implantation was followed up for 2 months.The objective response rate of the miR-7-5p high expression group was 65.0%(13/20),whereas the objective response rate of the miR-7-5p low expression group was 5.88%(1/17),and the difference between the two groups was statistically significant(χ^(2)=13.654,P<0.001).A total of 187 target genes were predicted using three databases.GO functional annotation showed that target genes were mainly involved in cellular response to insulin stimulus,regulation of gene expression by genetic imprinting,cytosol,peptidyl-serine phosphorylation,bHLH transcription factor binding,cargo loading into vesicles,cellular response to epinephrine stimulus,and nucleoplasm.KEGG pathway enrichment analysis showed that target genes were mainly involved in the ErbB signaling pathway,HIF-1 signaling pathway,axon guidance,longevity regulatory pathway,endocrine resistance,glioma,choline metabolism in cancer,and EGFR tyrosine kinase inhibitor drug resistance.Molecular complex detection analysis by Cytoscape revealed that PIGH,RAF1,EGFR,NXT2,PIK3CD,PIK3R3,ERBB4,TRMT13,and C5orf22 were the key modules of miR-7-5p target gene clustering.Conclusion The expression of miR-7-5p in pancreatic cancer tissues positively correlated with the radiosensitivity of ^(125)I seeds.Via targeted gene regulation,miR-7-5p acts on the network of multiple signaling pathways in PDAC and participates in its occurrence and development.Thus,miR-7-5p may become a predictive index of ^(125)I seed implantation therapy sensitivity in PDAC patients.
基金Supported by the Guangzhou Huadu District Science and Technology Project(No.20-HDWS-054).
文摘This case report describes a patient with advanced gallbladder cancer who developed septic shock associated with iodine-125(^(125)I)seed implantation.The treatment process is described to provide a clinical reference for similar cases.A 52-year-old woman with recurrence of advanced gallbladder cancer underwent ^(125)I seed implantation and developed postoperative sepsis with septic shock.The blood culture suggested infection with Aeromonas caviae and Enterococcus faecalis.Vancomycin and imipenem were immediately administered according to the drug sensitivity results,along with immunoglobulin therapy and vasoactive drugs.The patient’s condition gradually stabilized after comprehensive treatment.Sepsis with septic shock is a rare but potentially fatal complication of ^(125)I seed implantation.Timely administration of broad-spectrum antibiotics,immunoglobulin therapy,and vasoactive drugs is very important to stabilize the patient’s condition.Our treatment of this patient can serve as a reference for clinicians to manage this complication in similar cases.
文摘Cancer is a leading cause of death worldwide. In 2030, 26.4 million new cases will be diagnosed, with 17 million deaths accounted worldwide. Prostate cancer is the sixth most common type in the world, and the second most commom in men. For Brazil, the number of new cases of prostate cancer in 2010 is estimated to 52,350. Treatment of prostate cancer may be by surgery, radiation or even vigilant observation. A method of radiotherapy which has been extensively used is brachytherapy, where Iodine-125 seeds are placed inside or next to the area requiring treatment. Iodine seeds can be introduced loose seeds or stranded in bioabsorbable polymers in order to increase the dosimetric coverage of the prostate and reducing the chance of seed migration. Data were gathered concerning the commercialization of loose seeds and stranded seeds, between 2005 and 2011, in Brazil. It was noted that the number of stranded seeds commercialized in Brazil (around 80%) has always been much greater than the number of loose seeds, reaching 90% last year. The main reason is the reduction of the seed migration events into other parts of the body, since there is a potential hazard even considering that no harmful effect has been observe. The data regarding dosimetry are still controversial, since the seeds that migrate is normally no more than 1%.
文摘Background This study evaluated the clinical application of CT guided ^125iodine implantation in patients with portal vein tumor thrombus in primary hepatocellular carcinoma. Methods The ten patients （9 males and 1 female, aged from 36 to 72 years） with portal vein tumor thrombus accompanying hepatocellular carcinoma had been treated with comprehensive therapy including surgery, transcatheter arterial chemoembolization, radiotherapy ablation, microwave ablation or percutaneous ethanol injection. The average diameter of each tumor thrombus was 21.5 mm × 30.5 mm. Seeds of 30 MBq ^125I were implanted 5 mm apart within the portal vein tumor thrombus. The follow-up after 4 months included enhanced spiral CT. Results CT screening of the tumours indicated that 4 out of 10 patients showed complete response to the therapy, 5 partial response and 1 stable disease. Adverse effects included aggravated abdominal dropsy and temporarily increased transaminase, which were controlled by medical management. Severe complications such as haemorrhage, biliary fistula hepatic abscess, pancreatic fistula and hepatic function failure were not observed. Implanted seeds migrated to lung and left hepatic lobe in 1 case. Conclusion CT guided implantation of ^125iodine seeds, can effectively treat portal vein tumor thrombus accompanying hepatocellular carcinoma with minimal damage and few complications.
文摘Objective:To investigate patient-specific radioprotection mathods for people in close contact with cancer patientstreated by 12I-seed implantation.Methods:The initial dose rates(D_(0))at distances of 30 and 100 cm from 80 patients who had undergone ^(125)I-seed implantation were measured within 24 h of the procedure.The dose rate at t(D_(t))and effective dose(E)were calculated according to the measurad vales of D.The appropriate precaution times for general adult family members,spouses,coworkers,and children or pregnant women were determined,and the relationships between and precaution time for different close-contact groups were derived by curve-fitting the corresponding data.Results:The mean D vahes of 80 patients at distanes of 30 and 100cm were(15.24±11.25)μSv/h and(1.96±2.63)μSv/h,respectively(P<0.05).The mean values and range of precaution time for general adult familymembers,spouses,coworkers,and children or pregnant women were(4.17±16.55),(102.93±49.22),(51.00±61.29),and(34.27±56.90)d(0-90.61),(0-234.01),(0-247.81),and(0-224.69)d,respectively.Furthemore,a logarithmic relationship betwen D and precaution time(Y)was observed for the different groujps.The equations of these relationships were detemined to be Y=-131.569+83.256 lnD_(0) for general adult family mambers,Y=—108.532+83.318 lnD_(0) for spouses,Y=25.470+83.318 lnD,for coworkers,and Y=2.585+83.229 lnD_(0) for children or pregnant women.Conchusions:Some cancer patients treated by ^(125)I-seed brachytherapy emitover-dose levels of γ-rays,necessitatingradiation protection for their close contacts.However,appropriate patient-specific radiation protection fordifferent close contacts can be determined based on the precaution time calculated using the D_(0) value.
