Traditionally, during the follow-up and in order to receive 131 I therapy, patients with differentiated thyroid carcinoma (DTC) have to withdraw from using thyroid hormone. The hypothyroidism induced by hormone withdrawal can negatively affect the quality-of-life (QOL) of DTC patients. Without the hormone withdrawal, recombinant human thyroid-stimulating hormone-aided management of DTC patients can effectively obviate the consequences of hypothyroidism. This review will focus on the clinical application of recombinant human thyroid-stimulating hormone (rhTSH) in the management of DTC patients.
Humans ; Iodine Radioisotopes ; therapeutic use ; Thyroglobulin ; blood ; Thyroid Hormones ; administration & dosage ; Thyroid Neoplasms ; blood ; drug therapy ; radiotherapy ; Thyrotropin Alfa ; administration & dosage

OBJECTIVETo evaluate the clinical efficacy of transrectal 125 I seeds implantation brachytherapy (BT) combined with intermittent hormonal therapy (IHT) in the treatment of locally advanced prostate cancer.

METHODSWe treated 27 patients with locally advanced prostate cancer by transrectal 125I seeds implantation BT combined with IHT, and dynamically observed the changes in the PSA level, prostate volume, maximum urinary flow rate (Qmax) and International Prostate Symptoms Score (IPSS).

RESULTSAll the implantation procedures were completed smoothly, lasting 20 to 35 minutes, with 40 to 58 seeds implanted. At 6 months after implantation, the PSA level was < 0.2 microg/L in all the patients (< 0.1 microg/L in 19 cases), the prostate volume was significantly reduced (P < 0.05), and Qmax and IPSS remarkably improved (P < 0.05). At 3 years after implantation, 19 cases were in the first cycle and the other 8 in the third cycle of IHT, of which 2 progressed to androgen-independent prostate cancer, and another 2 developed early bone metastasis. The rates of 3-year biochemically and clinically progression-free survival were 70.3% and 85.2%, respectively, and the rate of therapeutic effectiveness was 92.6%. No severe complications occurred in any of the cases.

CONCLUSIONTransrectal 125I seeds implantation BT combined with IHT is a safe and minimally invasive procedure for locally advanced prostate cancer, which can effectively retard its clinical progression with no such complications as severe urethral, rectal or erectile dysfunction.

Aged ; Brachytherapy ; Combined Modality Therapy ; Hormones ; therapeutic use ; Humans ; Iodine Radioisotopes ; administration & dosage ; therapeutic use ; Male ; Prostatic Neoplasms ; radiotherapy ; therapy ; Treatment Outcome

Brachytherapy ; adverse effects ; Female ; Humans ; Iodine Radioisotopes ; administration & dosage ; therapeutic use ; Male ; Medical Staff, Hospital ; Occupational Exposure ; analysis ; Radiation Dosage ; Radiation Monitoring

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 (125)I 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 (125)I seed implantation in terms of local tumor control, survival time, pain relief and quality of life.
Adult ; Aged ; Drug-Eluting Stents ; adverse effects ; Female ; Humans ; Iodine Radioisotopes ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Pancreatic Neoplasms ; pathology ; radiotherapy ; Quality of Life ; Radiopharmaceuticals ; administration & dosage ; therapeutic use ; Survival Analysis

PURPOSE: The radioiodine ablation therapy is required for patients who underwent a total thyroidectomy. Through a comparative review of a low iodine diet (LID) and a restricted iodine diet (RID), the study aims to suggest guidelines that are suitable for the conditions of Korea. MATERIALS AND METHODS: The study was conducted with 101 patients. With 24-hour urine samples from the patients after a 2-week restricted diet and after a 4-week restricted diet, the amount of iodine in the urine was estimated. The consumed radioiodine amounts for 2 hours and 24 hours were calculated. RESULTS: This study was conducted with 47 LID patients and 54 RID patients. The amounts of iodine in urine, the 2-week case and 4-week case for each group showed no significant differences. The amounts of iodine in urine between the two groups were both included in the range of the criteria for radioiodine ablation therapy. Also, 2 hours and 24 hours radioiodine consumption measured after 4-week restrictive diet did not show statistical differences between two groups. CONCLUSION: A 2-week RID can be considered as a type of radioiodine ablation therapy after patients undergo a total thyroidectomy.
Ablation Techniques ; Adult ; Carcinoma/metabolism/*radiotherapy/surgery ; *Diet ; Female ; Humans ; Iodides/urine ; Iodine/administration & dosage/urine ; Iodine Radioisotopes/metabolism/*therapeutic use ; Male ; Middle Aged ; Republic of Korea ; Thyroid Neoplasms/metabolism/*radiotherapy/surgery ; Thyroidectomy ; Treatment Outcome

OBJECTIVETo compare the efficacies of portal vein stenting and transcatheter arterial chemoembolization (TACE) combined therapy performed with or without endovascular implantation of iodine-125 (125I) seeds strand in patients with hepatocellular carcinoma (HCC) and main portal vein tumor thrombus (MPVTT).

METHODSOne-hundred-and-six patients with HCC complicated by MPVTT who were treated with portal vein stents and TACE, either with (Group A, n=56) or without (Group B, n=50) endovascular implantation of 125I seeds strand, between July 2005 and April 2011, were retrospectively analyzed. Overall survival, stent patency, and procedure-related adverse events were compared between the two groups.

RESULTSThe technical success rate was 100% for placement of 125I seeds strands and stents in the obstructed main portal vein. No serious procedure-related adverse events were recorded. Group A had significantly higher median survival (335 days vs. group B: 146 days; P=0.001, hazard ratio (HR)=2.244). Additionally, group A had significantly higher median stent patency (400 days vs. group B: 190 days; P=0.005, HR=2.479).

CONCLUSIONThe combination therapeutic strategy of portal vein stenting and TACE with endovascular implantation of 125I seeds strands improves the survival of HCC patients with MPVTT complication.

Carcinoma, Hepatocellular ; complications ; therapy ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Female ; Humans ; Iodine Radioisotopes ; administration & dosage ; therapeutic use ; Liver Neoplasms ; therapy ; Male ; Middle Aged ; Neoplastic Cells, Circulating ; Portal Vein ; physiopathology ; surgery ; Retrospective Studies ; Stents ; Treatment Outcome ; Venous Thrombosis ; complications ; therapy

OBJECTIVETo evaluate the safety and efficacy of the united intraoperative (125)I seed implantation as a treatment option for thoracic advanced esophageal squamous cell carcinoma (ESCC).

METHODSFrom January 2000 to August 2004, according to preoperative CT staging criteria, 298 patients in phase II to III of ESCC had been enrolled in this prospective study. With informed consent, they were randomized into two groups: intraoperative (125)I seed implantation (group A) and surgery alone (group B). With 0.5 mCi of single seed, total activity in 10 to 30 mCi, matched peripheral dose in 60 to 70 Gy, 20 to 40 (125)I seeds were implanted into the target under direct vision in accordance with treatment planning system. The post-operative complications were observed. The validation and quality assessment of radioactive seeds were demonstrated according to CT scan or X imaging. The short-term efficacy was evaluated according to WHO criteria. The 1-, 3-, 5-, and 7-year survival rate were followed up.

RESULTSOn the close date of August 31st 2008, the satisfied quality assessment of (125)I seeds was observed. There was no displacement or loss of seed. The local recurrence rates in the group A and group B were 14.9% and 38.7%, respectively, which were statistically significant (P < 0.05). The complete response and partial response rate in the group A was 78.8%. It was significantly higher than 30.3% in the group B (P < 0.05). There was no statistical difference among groups when comparing the complications (P > 0.05). The 1-year survival rates were no statistical difference among the two groups. However, the 3-, 5-, and 7-year survival rates in group A (64.0%, 42.7%, and 25.1%) were statistically different from that in the B group (52.0%, 34.5%, and 12.6%) (P < 0.05).

CONCLUSIONSIt is safe, effective and simple application about the intraoperative (125)I seed implantation for advanced ESCC. It may reduce the local recurrence rate and improve survival.

Adult ; Aged ; Aged, 80 and over ; Brachytherapy ; Carcinoma, Squamous Cell ; radiotherapy ; surgery ; Esophageal Neoplasms ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Intraoperative Care ; Iodine Radioisotopes ; administration & dosage ; therapeutic use ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome

OBJECTIVETo assess the efficacy and safety of percutaneous cryoablation (PCC) and (125)I seed implantation combined with chemotherapy for advanced pancreatic cancer.

METHODSSixty-seven patients with advanced pancreatic cancer (6 in stage III, 61 in stage IV) received PCC and (125)I seed implantation combined with concomitant gemcitabine hydrochloride and DDP chemotherapy. The clinical benefit response (CBR), survival rate and therapy-related complications were assessed.

RESULTSAll patients except one were followed up over 1 year. The 6-month and 1-year survival rates were 84.8% and 33.4%, respectively. The median progression free survival were 6.3 months and 5.5 months in the group stage III and group stage IV (P > 0.05), respectively, while the overall survival was 9.1 months in the group stage III and 11.0 months in the group stage IV (P > 0.05). CR,PR and SD were achieved in 5, 8, 54 patients, respectively. Fifty-four and 50 in the 67 patients experienced a ≥ 50% reduction of pain score and analgesic consumption, respectively, 18 patients experienced a ≥ 2 kg weight gaining, and KPS was increasing from 71.2 ± 0.4 to (90.0 ± 0.3, P < 0.05), the overall benefit rate was 80.6%. No serious therapy-related complications except pancreatic fistula accompanied abdominal hemorrhage, bile leakage, acute pancreatitis and needle track seeding in 1, 1, 2 and 1 case, respectively.

CONCLUSIONPercutaneous cryoablation and (125)I seed implantation combined with chemotherapy are effective and safe for the treatment of advanced pancreatic cancer.

Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Brachytherapy ; methods ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; Cryosurgery ; methods ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Iodine Radioisotopes ; therapeutic use ; Liver Neoplasms ; secondary ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms ; pathology ; surgery ; therapy ; Survival Rate ; Young Adult

It has been shown that iodinated fatty acid esters such as Ethiodol(*) or Lipiodol(**) are selectively retained in hypervascular hepatic tumors following intrahepatic arterial admininstration. Such agents have been utilized in the detection and treatment of hepatocellular carcinoma (HCC) along with anticancer drug emulsions. Radioildination of Lipiodol(1-131-Lipiodol) was achieved by using a simple exchange method and the agent was used in the treatment of HCC following intrahepatic arterial-injection via superselective catheterization of tumor feeding vessels. Forty patients with HCC (massive 18; multinodular 12; infiltrative 10) were treated in an attempt to deliver a high dose of internal radiation; a cumulative tumor dose of 12,000 rad(120 GY) or higher was aimed in single or multiple procedures. Following therapy, the patients were divided into 2 groups, responsive or nonresponsive. Patients classfied as massive type responded to this treatment best (72.3%) followed by multinodular type (33.3%) and infiltrative type(10.0%). According to the size of tumor there was an 80.0% response for tumors of less than 5cm in diameter, 60.0%, between 5 to 8cm and 9.0% larger than 10cm in diameter. The clinical results of this treatment modality appear to be quite promising in the management of HCC, especially in the less than 8cm sized massive type of HCC. Also this method was able to not only provide long term local control but also a good quality of life without complications.
Adult ; Aged ; Carcinoma, Hepatocellular/blood supply/*radiotherapy ; Case Report ; Clinical Trials ; Female ; Hepatic Artery ; Human ; Injections, Intra-Arterial ; Iodine Radioisotopes/administration and dosage/*therapeutic use ; Iodized Oil/administration and dosage/*therapeutic use ; Liver Neoplasms/blood supply/*radiotherapy ; Male ; Middle Age ; Support, Non-U.S. Gov't

OBJECTIVETo evaluate the efficacy, toxicity and survival of intraoperative 125I brachytherapy combined with chemotherapy for advanced pancreatic cancer.

METHODSThirty-six patients with advanced pancreatic cancer were randomized to two groups: brachy-chemotherapy group (n = 18) and control group (n = 18). For the combined group, intraoperative 125I implantation and gemcitabine, 5-Fu were given. For the control group, intratumoral injection of absolute alcohol was done.

RESULTSThe CR + PR rate of brachy-chemotherapy group was 38.9% with pain relief in 77.8%, while that of control group was 0 with pain relief in 22.2% (P < 0.05). Although there were some toxicity in brachy-chemotherapy group, treatment was well tolerated. The 6-, 12-month survival rates of brachy-chemotherapy group were 71.4% and 21.4% and those of control group were 38.5% and 7.7%, respectively. The median survival time was 10.6 months and 5.2 months for the two groups, between which the difference was significant (P < 0.05).

CONCLUSIONInteroperative 125I brachytherapy combined with chemotherapy for advanced pancreatic cancer can control tumor, relieve pain and improve quality of life. It is safe and effective.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Brachytherapy ; Combined Modality Therapy ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Fluorouracil ; administration & dosage ; Humans ; Intraoperative Period ; Iodine Radioisotopes ; therapeutic use ; Male ; Middle Aged ; Neoplasm Staging ; Pancreatic Neoplasms ; drug therapy ; surgery ; therapy ; Quality of Life ; Survival Rate