OBJECTIVE: To investigate the clinical application and efficacy of ¹²⁵Ⅰ radioactive seeds implantation in the treatment of recurrent salivary gland carcinoma after external radiotherapy. METHODS: From July 2004 to July 2016, 43 cases of recurrent salivary gland carcinoma of the neck after external radiotherapy or surgery combined with external radiotherapy were treated. According to the conventional segmentation radiotherapy for head and neck cancer (once a day, 1.8-2.0 Gy each time, 5 days per week), the cumulative radiation dose of the patients in this group was calculated. In the study, 26 patients received 50-60 Gy, 7 patients received less than 50 Gy, 4 patients received 60-70 Gy, and 6 patients received more than 80 Gy (range: 80-120 Gy). The interval between the last external irradiation and local recurrence was 4-204 months, and the median interval was 48 months. Among them, 25 cases were treated with ¹²⁵Ⅰ radioactive seeds implantation only and 18 cases were treated with ¹²⁵Ⅰ radioactive seeds implantation after operation. The prescription dose was 100-140 Gy. The control rate, survival rate and disease-free survival rate were recorded to evaluate the side effects. RESULTS: The median follow-up time was 27 months (ranging from 2.5 to 149.0 months). Among them, the median follow-up time of adenoid cystic carcinoma patients was 31 months (range: 2.5-112.0 months), and the median follow-up time of mucoepidermoid carcinoma patients was 18 months (range: 5-149 months). The local control rates for 1, 3 and 5 years were 66.5%, 48.8% and 42.7%, respectively. The 1-, 3- and 5- year survival rates were 88.0%, 56.7% and 45.8%, respectively. The disease-free survival rates of 1, 3 and 5 years were 58.3%, 45.4% and 38.1%, respectively. There was no statistically significant difference in local control rate, survival rate, and disease-free survival between the radioactive seeds implantation group and the radioactive seeds implantation group after surgical resection. There were 2 cases of acute radiation reaction Ⅰ/Ⅱ and 3 cases of reaction Ⅲ or above. In the late stage of radiotherapy, there were 8 cases with Ⅰ/Ⅱ grade reaction and 3 cases with Ⅲ grade or above reaction. The incidence of radiation reactions of Grade Ⅲ and above was 7%. CONCLUSION ¹²⁵Ⅰ radioactive seeds implantation provides an alternative method for the treatment of recurrent salivary gland carcinoma after external radiotherapy. The local control rate and survival rate are improved on the premise of low incidence of side effects.
Brachytherapy/adverse effects* ; Humans ; Iodine Radioisotopes/therapeutic use* ; Neoplasm Recurrence, Local/radiotherapy* ; Salivary Gland Neoplasms/radiotherapy* ; Salivary Glands

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

Therapeutic plasma exchange (TPE) is one possible treatment for patients resistant to conventional antithyroid drugs or requiring urgent attention for thyrotoxicosis. We report a 35-yr-old man with thyrotoxicosis, ultimately attributed to Graves' disease in whom antithyroid drug used initially was soon discontinued, due to abnormal liver function, and replaced by Lugol's solution. Three weeks later, an escape phenomenon (to Lugol's solution) was apparent, so we performed TPE to control the thyrotoxicosis. Two courses of TPE by a centrifugal type machine resulted in diminished levels of thyroid hormone levels, which then rebounded after another two courses of membrane filtration type TPE. However, the patient could be treated with radioactive iodine therapy without any complications at present.
Adult ; Antithyroid Agents/adverse effects/therapeutic use ; Cetirizine/adverse effects/therapeutic use ; Graves Disease/*radiotherapy ; Hepatitis B, Chronic/complications ; Humans ; Iodides/therapeutic use ; Iodine Radioisotopes/*therapeutic use ; Male ; Methimazole/adverse effects/therapeutic use ; Plasmapheresis/*methods ; Thyroid Gland/*pathology ; Thyrotoxicosis/*therapy

OBJECTIVETo investigate the effects of brachytherapy with computed tomography-guided percutaneous radioactive I-125 seeds interstitial implantation (ISI) synchronized chemotherapy and Chinese medicine (CM) for the treatment of advanced stage of non-small cell lung cancer (NSCLC).

METHODSNinety patients diagnosed with NSCLC by biopsy were randomly assigned to three groups: the synchronized therapy group (A), the chemotherapy plus CM-treated group (B), and the chemotherapy-treated group (C); a 2-month course of treatment was administered to them all. The effectiveness of treatment was evaluated based on tumor size, tumor markers (carcinoembryonic, squamous cell carcinoma-associated antigen, and cytokeratin 19 fragment), clinical symptoms, and quality of life (QOL) in patients.

RESULTSThe total effective rates of Groups A to C were 83.33%, 46.67%, and 43.33%, respectively. The tumor markers were reduced obviously in Group A, showing signifificant difference compared with those in the other two groups. Additionally, QOL was elevated and cancer-related symptoms were alleviated more signifificant in Group A than those in Group C (all P<0.05).

CONCLUSIONThe synchronized therapy of I-125 implantation with chemotherapy and CM was a safe therapeutic method and can be regarded as a new mode for treatment of advanced-stage NSCLC.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Biomarkers, Tumor ; metabolism ; Brachytherapy ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; radiotherapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Iodine Radioisotopes ; Lung Neoplasms ; drug therapy ; radiotherapy ; Male ; Middle Aged ; Quality of Life ; Treatment Outcome

OBJECTIVETo study the efficacy and safety of 125I particle implantation in the treatment of rhabdomysarcoma (RMS) of the head and neck in children.

METHODSEight children (four males and four females) with RMS of the head and neck received 125I particle implantation targeted to the primary lesion area. The primary lesions were noted in eyelids or eyes in two children, in the orbit in four children, and in the nasal cavity or nasal wing in two children. Treatment outcomes and side effects were observed.

RESULTSThe follow-up visits averaged 45±17 months (median 43 months) in the eight children receiving 125I particle implantation. Five children achieved a complete remission, 2 children achieved a complete remission and 1 child died. The total survival rate was 88% in the 8 children. Local pigmentation was observed in all eight children (100%). Nubecula (one case), eyeball pain (one case), serious blurred vision (one case), cornea ulcer and blindness (one case) and bleeding of the nasal cavity (one case) were also observed. Except for nubecula and blindness, these side effects were improved by symptomatic treatment.

CONCLUSIONS125I particle implantation appears to be effective in the treatment of RMS of the head and neck in children. Most treatment-related side effects can be improved by symptomatic treatment.

Adolescent ; Brachytherapy ; adverse effects ; Child ; Child, Preschool ; Female ; Head and Neck Neoplasms ; radiotherapy ; Humans ; Iodine Radioisotopes ; adverse effects ; therapeutic use ; Male ; Rhabdomyosarcoma ; radiotherapy ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the feasibility, efficacy and safety of radioiondine therapy in the treatment of Graves hyperthyroidism with large goiter.

METHODSA total of 128 patients with Graves; hyperthyroidism with large goiter (thyroid weight>70 g) as the study group were treated with radioiondine, using 318 concurrent patients with Graves disease with a smaller goiter (thyroid weight<70 g) as the control group. The cure rate following a single-session treatment, the total cure rate and the incidence of hypothyroidism were compared between the two groups.

RESULTSIn the large goiter group, the total cure rate was 95.3%, and the cure rate following a single-session treatment was 46.9%, with the incidence of hypothyroidism of 4.7%, as compared with 90.9%, 65.7%, and 9.1% in the control group, respectively. A significant difference was noted in the cure rate following a single-session treatment (P=0.000), but not in the total cure rate or the incidence of early-onset hypothyroidism (P=0.115) between the two groups. No tracheal compression, laryngeal edema, or hyperthyroidism crisis occurred in the large goiter group after the treatment.

CONCLUSIONRadioiondine is safe and effective for treatment of Graves hyperthyroidism with large goiter, and results in a total cure rate and incidence of early-onset hypothyroidism similar to those in patients with goiters of a smaller size.

Adolescent ; Adult ; Aged ; Female ; Graves Disease ; pathology ; radiotherapy ; Humans ; Iodine Radioisotopes ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Organ Size ; Thyroid Gland ; pathology ; Treatment Outcome ; Young Adult

The objective of this work was to observe the side effects on the peripheral blood treated with 131I in children and adolescents with differentiated thyroid carcinoma (DTC). The levels of white blood cells (WBC), neutrophil, HGB (hemoglobin), RBC (red blood cells) and the PLT (platelet) were measured by automatic hemocyte analyzer in 31 young enrolled patients (< or = 20 years old) before 131I therapy, 1 month and 6 months after 131I therapy, and at the end of follow up. The results of 131I treatment at the before and after the treatment were compared. The level of PLT decreased obviously (P < 0.01), WBC, RBC and HGB decreased (P < 0.05), neutrophil increased slightly (P > 0.05) 1 month after 131I therapy. The level of WBC, neutrophil, RBC, HGB and PLT were near to the level of before treatment after 6 months (P > 0.05) of 131I therapy. At the end of follow up, the components of the peripheral blood in the high dose group (7.4GBq-11.1GBq) were not significantly different from those at the beginning. The results showed that, there was only a transient impact on the peripheral blood by the 131I therapy in the children and adolescents with differentiated thyroid carcinoma.
Adolescent ; Blood Cell Count ; Carcinoma ; blood ; radiotherapy ; Female ; Humans ; Iodine Radioisotopes ; adverse effects ; therapeutic use ; Male ; Thyroid Neoplasms ; blood ; radiotherapy ; Young Adult

OBJECTIVETo compare the efficacy and toxicity of chemotherapy combined with insterstitial (125)I seed implantation brachytherapy in unresectable staged IIIa/IIIb non-small cell lung cancer.

METHODSSeventy six patients with staged IIIa/IIIb non-small cell lung cancer were included in this study. Among them 37 cases were of the study group, treated with NP/GP scheme synchronization chemotherapy combined with (125)I seed implantation brachytherapy, while 39 cases in the control group were given NP/GP scheme chemotherapy. The cumulative survival time and median survival time of the two groups were compared by Kaplan-Meier analysis. The difference of mean survival time between the two groups was analyzed by log-rank method.

RESULTSThe study group and the control group achieved a total response rate of 56.8% and 30.8%, local control rate of 78.4% and 56.4%, respectively, showing a statistically significant difference (P < 0.05). The 1-year survival rates of the study group and control group were 66.7% and 45.3%, and the median survival times 15.4 and 11.5 months, respectively, with a significant difference between the 2 groups (P < 0.05). The total chemotherapy toxicity rate of the two groups showed no significant difference (P > 0.05).

CONCLUSIONThe (125)I seed implantation brachytherapy combined with concurrent chemotherapy shows a low complication rate, acceptable toxicity, and good therapeutic effectiveness, and is an effective and satisfactory therapeutic modality in the management of locally advanced non-small cell lung cancer.

Alopecia ; etiology ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Brachytherapy ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; radiotherapy ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Diarrhea ; etiology ; Female ; Follow-Up Studies ; Humans ; Iodine Radioisotopes ; adverse effects ; therapeutic use ; Leukopenia ; etiology ; Lung Neoplasms ; drug therapy ; pathology ; radiotherapy ; Male ; Middle Aged ; Neoplasm Staging ; Remission Induction ; Survival Rate ; Vinblastine ; administration & dosage ; analogs & derivatives ; Vomiting ; etiology

BACKGROUND(131)I therapy is recognized as the simplest, safest, least expensive, and most effective treatment, and accepted by more and more patients. However its curative effect is influenced by many factors, therefore there are some difficulties for doctors to establish individual treatment strategy. The aims of this study were to determine the incidence of early and late hypothyroidism after (131)I treatment for Graves' disease (GD) and to compare their correlation, to observe and analyze the influential factors and to understand the predictabilities of them.

METHODSFive hundred GD patients (144 males, 356 females; age (41.2 +/- 12.3) years) received (131)I treatment for the first time. The therapeutic procedure was carried out as the following: undergoing (131)I uptake test to obtain maximum of thyroid uptake value and effective half-life (EHL) time; estimating the thyroid's weight by ultrasonography; determination of thyroid hormones and correlative antibodies; pre-therapy physical examination; thyroid imaging; calculating (131)I therapeutic dosage; per os uptake of the determined (131)I dosage; follow-up appraisal of curative effect. The observing parameters included age, gender, thyroid weight, GD duration, condition of onset, state of disease, course of treatment, EHL time, maximum of thyroid uptake value, (131)I dosage and titer of correlative antibodies. We sorted out the data and used both univariate and multivariate analysis to evaluate them statistically.

RESULTSThe incidence rates of early and late hypothyroidism were 33.2% and 6.6% respectively after (131)I treatment and approximately 22.2% cases of late hypothyroidism developed from early hypothyroidism. The influential factors of early hypothyroidism included course of GD, the highest thyroid uptake ratio of (131)I, EHL time and thyroid microsome antibody (TMAb), etc. A multivariate analysis on late hypothyroidism showed that female patients, with recurrence after anti-thyroid drug treatment and higher thyroid weight, had lower possibility of late hypothyroidism after (131)I therapy.

CONCLUSIONSThe incidence of early hypothyroidism is higher than that of late hypothyroidism. The highest thyroid uptake ratio of (131)I, EHL and TMAb will increase the possibility of early hypothyroidism, while GD course is the protective factor. Higher (131)I dosage, longer EHL and higher TMAb titer will also increase the possibility of late hypothyroidism. The multi-perspective and multi-factor analysis has the benefit to establish individualized treatment strategy.

Adult ; Female ; Graves Disease ; radiotherapy ; Humans ; Hypothyroidism ; epidemiology ; etiology ; Iodine Radioisotopes ; adverse effects ; therapeutic use ; Logistic Models ; Male ; Middle Aged ; Time Factors

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