Implantation of radioactive 125I seeds improves the prognosis of locally advanced pancreatic cancer patients: A retrospective study

  • Yong-feng Li (李永峰)
  • Zhi-qiang Liu (刘志强)
  • Yu-shun Zhang (张禹舜)
  • Li-ming Dong (董黎明)
  • Chun-you Wang (王春友)
  • Shan-miao Gou (勾善淼)
  • He-shui Wu (吴河水)
Article
First Online:
Received:
Revised:

Summary

Locally advanced pancreatic cancer is associated with a very poor prognosis. This study was performed to evaluate whether patients with locally advanced pancreatic cancer benefit from 125I seed implantation. This retrospective study included 224 patients with locally advanced pancreatic cancer, with 137 patients (61.2%) in the implantation (IP) group and 87 (38.9%) in the non-implantation (NIP) group. The survival status, complications and objective curative effects were compared between the groups. The average operative time in the IP group was significantly longer than that in the NIP group (243±51 vs. 214±77 min). The tumor response rates were 9.5% and 0 at the 2nd month after surgery in the IP and NIP groups, respectively (P<0.05). The IP group exhibited a trend toward pain relief at the 6th month after surgery. The global health status scores of the IP group were higher than those of the NIP group at the 3rd and 6th month after surgery. The median survival time in the IP group was significantly longer than that in the NIP group. In conclusion, patients with locally advanced pancreatic cancer can benefit from 125I seed implantation in terms of local tumor control, survival time, pain relief and quality of life.

Key words

125I seed implantation locally advanced pancreatic cancer pain relief quality of life 
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Fortner JG. Regional resection and pancreatic carcinoma. Surgery, 1973,73(5):799–800PubMedGoogle Scholar
  2. 2.
    Bachellier P, Nakano H, Oussoultzoglou PD, et al. Is pancreaticoduodenectomy with mesentericoportal venous resection safe and worthwhile? Am J Surg, 2001,182(2):120–129CrossRefPubMedGoogle Scholar
  3. 3.
    Carrere N, Sauvanet A, Goere D, et al. Pancreaticoduodenectomy with mesentericoportal vein resection for adenocarcinoma of the pancreatic head. World J Surg, 2006,30(8):1526–1535CrossRefPubMedGoogle Scholar
  4. 4.
    Reddy SK, Tyler DS, Pappas TN, et al. Extended resection for pancreatic adenocarcinoma. Oncologist, 2007,12(6):654–663CrossRefPubMedGoogle Scholar
  5. 5.
    Ghaneh P, Costello E, Neoptolemos JP. Biology and management of pancreatic cancer. Gut, 2007,56(8):1134–1152CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Tempero M, Arnoletti JP, Ben-Josef E, et al. Pancreatic adenocarcinoma. Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2007,5(10):998–1033PubMedGoogle Scholar
  7. 7.
    Wang C, Wu H, Xiong J, et al. Pancreaticoduodenectomy with vascular resection for local advanced pancreatic head cancer: a single center retrospective study. J Gastrointest Surg, 2008,12(12):2183–2190CrossRefPubMedGoogle Scholar
  8. 8.
    Burris HA, 3rd, Moore MJ, Andersen J, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol, 1997,15(6): 2403–2413PubMedGoogle Scholar
  9. 9.
    Grunewald R, Abbruzzese JL, Tarassoff P, et al. Saturation of 2',2'-difluorodeoxycytidine 5'-triphosphate accumulation by mononuclear cells during a phase I trial of gemcitabine. Cancer Chemother Pharmacol, 1991,27(4): 258–262CrossRefPubMedGoogle Scholar
  10. 10.
    Bahn BM, Erdek MA. Celiac plexus block and neurolysis for pancreatic cancer. Curr Pain Headache Rep, 2013,17(2):310CrossRefPubMedGoogle Scholar
  11. 11.
    Kaufman M, Singh G, Das S, et al. Efficacy of endoscopic ultrasound-guided celiac plexus block and celiac plexus neurolysis for managing abdominal pain associated with chronic pancreatitis and pancreatic cancer. J Clin Gastroenterol, 2010,44(2):127–134CrossRefPubMedGoogle Scholar
  12. 12.
    Jin Z, Du Y, Li Z, et al. Endoscopic ultrasonography-guided interstitial implantation of iodine 125-seeds combined with chemotherapy in the treatment of unresectable pancreatic carcinoma: a prospective pilot study. Endoscopy, 2008,40(4):314–320CrossRefPubMedGoogle Scholar
  13. 13.
    Sun S, Xu H, Xin J, et al. Endoscopic ultrasound-guided interstitial brachytherapy of unresectable pancreatic cancer: results of a pilot trial. Endoscopy, 2006,38(4):399–403CrossRefPubMedGoogle Scholar
  14. 14.
    Wang KX, Jin ZD, Du YQ, et al. EUS-guided celiac ganglion irradiation with iodine-125 seeds for pain control in pancreatic carcinoma: a prospective pilot study. Gastrointest Endosc, 2012,76(5):945–952CrossRefPubMedGoogle Scholar
  15. 15.
    Xu KC, Niu LZ, Hu YZ, et al. A pilot study on combination of cryosurgery and (125)iodine seed implantation for treatment of locally advanced pancreatic cancer. World J Gastroenterol, 2008,14(10):1603–1611CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Wang CF, Zhao P, Li YX, et al. Role of 125I seed implantation in treatment of unresectable pancreatic cancer. Zhonghua Yi Xue Za Zhi (Chinese), 2010,90(2):92–95Google Scholar
  17. 17.
    Schuricht AL, Spitz F, Barbot D, et al. Intraoperative radiotherapy in the combined-modality management of pancreatic cancer. Am Surg, 1998,64(11):1043–1049PubMedGoogle Scholar
  18. 18.
    Tempero MA, Arnoletti JP, Behrman SW, et al. Pancreatic Adenocarcinoma, version 2.2012: featured updates to the NCCN Guidelines. J Natl Compr Canc Netw, 2012,10(6):703–713PubMedPubMedCentralGoogle Scholar
  19. 19.
    Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst, 2000,92(3):205–216PubMedGoogle Scholar
  20. 20.
    Sprangers MA, Cull A, Bjordal K, et al. The European Organization for Research and Treatment of Cancer. Approach to quality of life assessment: guidelines for de veloping questionnaire modules. EORTC Study Group on Quality of Life. Qual Life Res, 1993,2(4):287–295Google Scholar
  21. 21.
    Osoba D, Rodrigues G, Myles J, et al. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol, 1998,16(1):139–144PubMedGoogle Scholar
  22. 22.
    Moertel CG, Frytak S, Hahn RG, et al. Therapy of locally unresectable pancreatic carcinoma: a randomized comparison of high dose (6000 rads) radiation alone, moderate dose radiation (4000 rads + 5-fluorouracil), and high dose radiation + 5-fluorouracil: The Gastrointestinal Tumor Study Group. Cancer, 1981,48(8):1705–1710CrossRefPubMedGoogle Scholar
  23. 23.
    Loehrer PJS, Powell ME, Cardenes HR, et al. A randomized phase III study of gemcitabine in combination with radiation therapy versus gemcitabine alone in patients with localized, unresectable pancreatic cancer: E4201. J Clin Oncol, 2008,26(15):431–436Google Scholar
  24. 24.
    Huguet F, Andre T, Hammel P, et al. Impact of chemoradiotherapy after disease control with chemotherapy in locally advanced pancreatic adenocarcinoma in GERCOR phase II and III studies. J Clin Oncol, 2007,25(3):326–331CrossRefPubMedGoogle Scholar
  25. 25.
    Kim R, Saif MW. Is there an optimal neoadjuvant therapy for locally advanced pancreatic cancer? JOP, 2007,8(3):279–288PubMedGoogle Scholar
  26. 26.
    Chauffert B, Mornex F, Bonnetain F, et al. Phase III trial comparing intensive induction chemoradiotherapy (60 Gy, infusional 5-FU and intermittent cisplatin) followed by maintenance gemcitabine with gemcitabine alone for locally advanced unresectable pancreatic cancer. Definitive results of the 2000-01 FFCD/SFRO study. Ann Oncol, 2008,19(9):1592–1599PubMedGoogle Scholar
  27. 27.
    Regine WF, Winter KA, Abrams RA, et al. Fluorouracil vs gemcitabine chemotherapy before and after fluorouracil-based chemoradiation following resection of pancreatic adenocarcinoma: a randomized controlled trial. JAMA, 2008,299(9):1019–1026CrossRefPubMedGoogle Scholar
  28. 28.
    Yovino S, Poppe M, Jabbour S, et al. Intensity-modulated radiation therapy significantly improves acute gastrointestinal toxicity in pancreatic and ampullary cancers. Int J Radiat Oncol Biol Phys, 2011,79(1):158–162CrossRefPubMedGoogle Scholar
  29. 29.
    Chang DT, Schellenberg D, Shen J, et al. Stereotactic radiotherapy for unresectable adenocarcinoma of the pancreas. Cancer, 2009,115(3):665–672CrossRefPubMedGoogle Scholar
  30. 30.
    Guarneri A, Botticella A, Filippi AR, et al. 125I brachytherapy for localized prostate cancer: a single institution experience. Tumori, 2013,99(1):83–87PubMedGoogle Scholar
  31. 31.
    Akane S, Hiromichi I, Takefumi S, et al. 125Iodine monotherapy for Japanese men with low- and intermediate-risk prostate cancer: outcomes after 5 years of follow-up. J Radiat Res, 2013,55(2):328–333Google Scholar
  32. 32.
    Baltas D, Lymperopoulou G, Loffler E, et al. A radiobiological investigation on dose and dose rate for permanent implant brachytherapy of breast using 125I or 103Pd sources. Med Phys, 2010,37(6):2572–2586CrossRefPubMedGoogle Scholar
  33. 33.
    Gao F, Li C, Gu Y, et al. CT-guided 125I brachytherapy for mediastinal metastatic lymph nodes recurrence from esophageal carcinoma: effectiveness and safety in 16 patients. Eur J Radiol, 2013,82(2):e70–75CrossRefPubMedGoogle Scholar
  34. 34.
    Zhang S, Zheng Y, Yu P, et al. The combined treatment of CT-guided percutaneous 125I seed implantation and chemotherapy for non-small-cell lung cancer. J Cancer Res Clin Oncol, 2011,137(12):1813–1822CrossRefPubMedGoogle Scholar
  35. 35.
    D'Angio G, Hilaris BS, Arthur K, et al. Iodine 125 implantation for unresectable cancer of the pancreas. Postgrad Med, 1970,47(3):226–230PubMedGoogle Scholar
  36. 36.
    Shipley WU, Nardi GL, Cohen AM, et al. Iodine-125 implant and external beam irradiation in patients with localized pancreatic carcinoma: a comparative study to surgical resection. Cancer, 1980,45(4):709–714CrossRefPubMedGoogle Scholar
  37. 37.
    Mohiuddin M, Rosato F, Barbot D, et al. Long-term results of combined modality treatment with I-125 implantation for carcinoma of the pancreas. Int J Radiat Oncol Biol Phys, 1992,23(2):305–311CrossRefPubMedGoogle Scholar
  38. 38.
    Zou YP, Li WM, Zheng F, et al. Intraoperative radiofrequency ablation combined with 125 iodine seed implantation for unresectable pancreatic cancer. World J Gastroenterol, 2010,16(40):5104–5110CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Zhang FJ, Wu PH, Zhao M, et al. CT guided radioactive seed 125I implantation in treatment of pancreatic cancer. Zhonghua Yi Xue Za Zhi (Chinese). 2006,86(4):223–227Google Scholar
  40. 40.
    Zhongmin W, Yu L, Fenju L, et al. Clinical efficacy of CT-guided iodine-125 seed implantation therapy in patients with advanced pancreatic cancer. Eur Radiol, 2010,20(7):1786–1791CrossRefPubMedGoogle Scholar
  41. 41.
    Yu YP, Jiang HT, Yao Z, et al. Feasibility and safety of CT-guided percutaneous needle biopsy and subsequent iodine-125 seed interstitial implantation for pancreatic cancer. Zhonghua Zhong Liu Za Zhi (Chinese), 2013,35(8):608–612Google Scholar
  42. 42.
    Joyce F, Burcharth F, Holm HH, et al. Ultrasonically guided percutaneous implantation of iodine-125 seeds in pancreatic carcinoma. Int J Radiat Oncol Biol Phys, 1990,19(4):1049–1052CrossRefPubMedGoogle Scholar
  43. 43.
    Du Y, Jin Z, Meng H, et al. Long-term effect of gemcitabine-combined endoscopic ultrasonography-guided brachytherapy in pancreatic cancer. J Interv Gastroenterol, 2013,3(1):18–24CrossRefGoogle Scholar

Copyright information

© Huazhong University of Science and Technology and Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Yong-feng Li (李永峰)
    • 1
  • Zhi-qiang Liu (刘志强)
    • 1
  • Yu-shun Zhang (张禹舜)
    • 1
  • Li-ming Dong (董黎明)
    • 1
  • Chun-you Wang (王春友)
    • 1
  • Shan-miao Gou (勾善淼)
    • 1
  • He-shui Wu (吴河水)
    • 1
  1. 1.Pancreatic Disease Institute, Department of General Surgery, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

Personalised recommendations