Objectives: Hydrogel spacer (HS) was developed to reduce rectal toxicities caused by radiotherapy, but has been reported to cause major adverse events. Our institute has attempted to introduce a hyaluronic acid (HA) a...Objectives: Hydrogel spacer (HS) was developed to reduce rectal toxicities caused by radiotherapy, but has been reported to cause major adverse events. Our institute has attempted to introduce a hyaluronic acid (HA) as an alternative spacer. This study aimed to compare rectal doses and geometric distributions between the HS and HA implantation in prostate cancer.Methods: HS and HA were inserted in 20 and 18 patients undergoing high-dose brachytherapy, respectively. The rectum spacer volumes injected were 10 mL and 22 mL, respectively. In the treatment planning system, 13.5 Gy was administered with common catheter positions. The rectal dose indices were assessed between the spacer groups for dosimetry evaluation. Distances between the prostate and rectum and configurations of the spacers were compared.Results: The mean doses irradiated to 0.1 and 2 mL of the rectum were 10.45 Gy and 6.71 Gy for HS, and 6.73 Gy and 4.90 Gy for HA (p<0.001). The mean minimum distances between the prostate and rectum were 1.23 cm and 1.79 cm for HS and HA, respectively (p<0.05). Geometrical configuration comparisons revealed that HA has a higher ability to expand the space than HS.Conclusion: The rectal dose reduction ability of HA is significantly greater than that of HS, suggesting its potential as a new spacer.展开更多
OBJECTIVE The purpose of the study was to examine the efficacy of treating patients with advanced gastric cancer using iodine-125 （^125Ⅰ） brachytherapy. METHODS Ten patients with unresectable advanced gastric cance...OBJECTIVE The purpose of the study was to examine the efficacy of treating patients with advanced gastric cancer using iodine-125 （^125Ⅰ） brachytherapy. METHODS Ten patients with unresectable advanced gastric cancer were selected based on their pattern of CT scans. We utilized a brachytherapy planning system to determine the distribution of the ^125Ⅰ seeds, their activity and quantity. The matched peripheral dose （MPD） was 110-135 Gy.^125Ⅰ seeds were implanted in a single plane or biplane by an intraoperative small incision or percutaneous puncture. The postoperative hemogram, CT, KPS, pain-relieving period and survival period were recorded. RESULTS One patient developed a complete response （CR）, 4 patients a partial response （PR）, 3 patients showed no change （NC） and 2 patients developed progressive disease （PD）. The overall response rate （CR＋PR） was 50% （5/10）. The pain-relieving rate was 89% （8/9）. The patients＇ appetite and KPS were improved. The longest survival period was 10 months and median life span was 4 months. There were 8 patients whose seeds fell off resulting in an expulsion rate of 3.8% （26/692）. The patients showed 0-1 degree acute radio-therapeutic side-effects without other symptoms such as abdominal pain, vomitus cruentes or intestinal obstruction etc.CONCLUSION Applying ^125Ⅰ implantation to treat advanced gastric cancer with a reasonable seed distribution can significantly improve clinical symptoms and their quality of life. The radioactive damage is mild. This method can be used as an important supplementary treatment for unresectable advanced gastric cancer.展开更多
文摘Objectives: Hydrogel spacer (HS) was developed to reduce rectal toxicities caused by radiotherapy, but has been reported to cause major adverse events. Our institute has attempted to introduce a hyaluronic acid (HA) as an alternative spacer. This study aimed to compare rectal doses and geometric distributions between the HS and HA implantation in prostate cancer.Methods: HS and HA were inserted in 20 and 18 patients undergoing high-dose brachytherapy, respectively. The rectum spacer volumes injected were 10 mL and 22 mL, respectively. In the treatment planning system, 13.5 Gy was administered with common catheter positions. The rectal dose indices were assessed between the spacer groups for dosimetry evaluation. Distances between the prostate and rectum and configurations of the spacers were compared.Results: The mean doses irradiated to 0.1 and 2 mL of the rectum were 10.45 Gy and 6.71 Gy for HS, and 6.73 Gy and 4.90 Gy for HA (p<0.001). The mean minimum distances between the prostate and rectum were 1.23 cm and 1.79 cm for HS and HA, respectively (p<0.05). Geometrical configuration comparisons revealed that HA has a higher ability to expand the space than HS.Conclusion: The rectal dose reduction ability of HA is significantly greater than that of HS, suggesting its potential as a new spacer.
文摘OBJECTIVE The purpose of the study was to examine the efficacy of treating patients with advanced gastric cancer using iodine-125 （^125Ⅰ） brachytherapy. METHODS Ten patients with unresectable advanced gastric cancer were selected based on their pattern of CT scans. We utilized a brachytherapy planning system to determine the distribution of the ^125Ⅰ seeds, their activity and quantity. The matched peripheral dose （MPD） was 110-135 Gy.^125Ⅰ seeds were implanted in a single plane or biplane by an intraoperative small incision or percutaneous puncture. The postoperative hemogram, CT, KPS, pain-relieving period and survival period were recorded. RESULTS One patient developed a complete response （CR）, 4 patients a partial response （PR）, 3 patients showed no change （NC） and 2 patients developed progressive disease （PD）. The overall response rate （CR＋PR） was 50% （5/10）. The pain-relieving rate was 89% （8/9）. The patients＇ appetite and KPS were improved. The longest survival period was 10 months and median life span was 4 months. There were 8 patients whose seeds fell off resulting in an expulsion rate of 3.8% （26/692）. The patients showed 0-1 degree acute radio-therapeutic side-effects without other symptoms such as abdominal pain, vomitus cruentes or intestinal obstruction etc.CONCLUSION Applying ^125Ⅰ implantation to treat advanced gastric cancer with a reasonable seed distribution can significantly improve clinical symptoms and their quality of life. The radioactive damage is mild. This method can be used as an important supplementary treatment for unresectable advanced gastric cancer.
