Abstract:Objective To study the short-term efficacy of computed tomography (CT)-guided iodine-125(125I) radioactive seed implantation in the treatment of hypoxic tumors. Methods Twenty-two patients treated with 125I radioactive seed implantation in our department from 2014 to 2016 were divided into hypovascular tumor group (hypoxic group,n=12) and hypervascular tumor group (non-hypoxic group,n=10) based on the hemodynamics of solid tumor evaluated by color Doppler ultrasound. The enhanced CT images were loaded to the three-dimensional particle implantation planning system for preoperative planning. After 125I radioactive seed implantation,the D90 for target volume was verified to be 106-128 cGy. Treatment outcomes were evaluated according to the World Health Organization criteria at 1-3 months after surgery. Results In all the patients, the overall response rate was 82% at 3 months after surgery. There were no significant differences in response (complete response+ partial response) rates at 1, 2, or 3 months after surgery between the hypoxic group and the non-hypoxic group (P=0.840, 0.696, 0.840). Conclusions In the treatment of solid malignant tumor, 125I radioactive seed implantation can overcome the resistance of hypoxic tumor to radiotherapy in vitro and achieve satisfactory short-term efficacy.
. Short-term efficacy of iodine-125 radioactive seed implantation therapy for hypoxic tumors[J]. Chinese Journal of Radiation Oncology, 2018, 27(5): 478-482.
[1]Canoglu A,Gögüs Ç, Bedük Y,et al. Microvessel density as a prognostic marker in bladder carcinoma:correlation with tumor grade,stage and prognosis[J].Int Urol Nephrol,2004,36(3):401-405.DOI:10.1007/s11255-004-8869-9. [2]Tsutsui S, Kume M, Era S. Prognostic value of micro vessel density in invasive ductal carcinoma of the breast[J]. Breast Cancer, 2003, 10(4):312-319. DOI:10.1007/BF02967651. [3]Price P, Mcmillan TJ. The use of non-clonogenic assays in measuring the response of cells in vitro to ionising radiation.[J]. Eur J Cancer, 1994, 30 A (6):838-841. [4]Tom-a Dau I, Dau A, Karlsson M. The relationship between temporal variation of hypoxia, polarographic measurements and predictions of tumor response to radiation.[J]. Phys Med Biol.2004, 49(19):4463-4475. DOI:10.1088/0031-9155/49/19/002. [5]Toma-Dasu I, Dasu A, Waites A, et al. Theoretical simulation of oxygen tension measurement in the tissue using a microelectrode:Ⅱ. Simulated measurements in tissues. Radiother Oncol. 2002, 64(1):109-118. DOI:10.1016/S0167-8140(02)00148-2. [6]王俊杰,张福君.肿瘤放射性粒子治疗规范.第一版.人民卫生出版社.2016:9-11. Wang JJ, Zhang FJ. Code for the treatment of tumor radioactive particles. First edition. PMPH. 2016:9-11. [7]Di Martino EFN, Gagel B, Schramm O, et al. Evaluation of tumor oxygenation by color duplex sonography:a new approach[J]. Otolaryngol Head Neck Surg, 2005, 132(5):765-769.DOI:10.1016/j.otohns.2005.01.033. [8]Adler DD, Carson PL, Rubin JM, et al. Doppler ultrasound color flow imaging in the study of breast cancer:preliminary findings. Ultrasound Med Biol, 1990,16(6):553-559. DOI:10.1016/0301-5629(90)90020-D. [9]陈克敏,王忠敏.放射性粒子植入技术临床应用[M].北京:科学出版社,2011. Chen KM, Wang ZM. Clinical application of radioactive particle implantation[M].Beijing:Science Press,2011. [10]王俊杰,柴树德,郑广钧,等.3D打印模板辅助CT引导放射性125I粒子植入治疗肿瘤专家共识[J].中华放射医学与防护杂志,2017,37(3):161-170.DOI:10.3760/cma.j.issn.0254-5098.2017.03.001. Wang JJ,Chai SD,Zheng GJ,et al. Expert consensus on 3D-printing template assisted CT-guided radioactive 125I seed implantation brachytherapy[J].Chin J Radiol MedProt,2017,37(3):161-170.DOI:10.3760/cma.j.issn.0254-5098.2017.03.001. [11]王俊杰,修典荣,冉维强.放射性粒子组织间近距离治疗肿瘤[M].2版.北京:北京大学医学出版社,2004:20-25. Wang JJ,Xiu DR,Ran WQ.Brachytherapy of tumor with radioactive particle tissue[M].2 ed. Beijing:Peking University Medical Press,2004:20-25. [12]Joiner M, Van Der Kogel A.临床放射生物学基础[M].王中敏,译.北京:军事医学科学出版社,2010:188-196. Joiner M, Van Der Kogel A. Basic clinical radiobiology[M].Wang ZM,translation. Beijing:Military Medical Science Press,2010:188-196. [13]丁洪基.肿瘤微血管密度检测及其临床病理意义[J].诊断病理学杂志,2008,15(3):241-243.DOI:10.3969/j.issn.1007-8096.2008.03.026. Ding HJ.Detection of tumor microvessel density and its clinicopathological significance[J].J Diagnost Pathol,2008,15(3):241-243.DOI:10.3969/j.issn.1007-8096.2008.03.026. [14]韦力,周军.超声评价肿瘤血管生成及其生物学行为的研究进展[J].中国医学影像学杂志,2012,20(1):58-61.DOI:10.3969/j.issn.1005-5185.2012.01.019. Wei L,Zhou J.Ultrasonographic evaluation of tumor angiogenesis and its biological behavior[J].Chin J Med Imag,2012,20(1):58-61.DOI:10.3969/j.issn.1005-5185.2012.01.019. [15]娄成,钱建新,顾小强,等.125I粒子植入治疗盆腔及后腹膜肿瘤23例分析[J].介入放射学杂志,2016,25(7):631-634.DOI:10.3969/j.issn.1008-794X.2016.07.021. Lou C,Qian JX,Gu XQ,et al.125I seed implantation for the treatment of pelvic and retroperitoneal malignant tumors:clinical analysis of 23 patients[J].J Intervent Radiol, 2016,25(7):631-634.DOI:10.3969/j.issn.1008-794X.2016.07.021. [16]张涛,张福君,焦德超,等.125I粒子组织间植入治疗头颈部复发和转移恶性肿瘤[J].中国微创外科杂志,2008,8(5):445-447.DOI:10.3969/j.issn.1009-6604.2008.05.025. Zhang T,Zhang FJ,Jiao DC,et al. Interstitial implantation of 125I seeds for recurrent or metastatic malignant tumor at the head and neck[J].Chin J Min Inva Surg,2008,8(5):445-447.DOI:10.3969/j.issn.1009-6604.2008.05.025. [17]宁厚法,张凤莲,王滨,等.CT引导下经皮穿刺植入125I粒子治疗肺癌近期疗效观察[J].中国介入影像与治疗学,2009,6(3):251-254. Ning HF,Zhang FL,Wang B,et al. Short-term observation of CT-guided percutaneous implantation of Iodine-125 seeds for treatment of lung cancer[J].Chin J Interv Imaging Ther,2009,6(3):251-254. [18]汪建华,左长京,邵成伟,等.CT引导下125Ⅰ粒子植入治疗腹部淋巴结转移癌的临床应用[J].介入放射学杂志,2011,20(11):877-881.DOI:10.3969/j.issn.1008-794X.2011.11.011. Wang JH,Zuo CJ,Shao CW,et al. CT-guided 125Ⅰ seed brachytherapy for abdominal metastatic lymph nodes[J].J Intervent Radiol,2011,20(11):877-881.DOI:10.3969/j.issn.1008-794X.2011.11.011. [19]王晓慧,杨国仁.肿瘤乏氧原理及乏氧显像的研究进展简述[J].当代医学,2009,15(8):99-103.DOI:10.3969/j.issn.1009-4393.2009.08.020. Wang XH,Yang GR.A compendium for the progress in the principium and imaging of tumor hypoxia[J].Contemp Med,2009,15(8):99-103.DOI:10.3969/j.issn.1009-4393.2009.08.020. [20]许飞,刘建军,黄钢,等.PET乏氧显像在预测肿瘤乏氧及指导临床治疗中的应用进展[J].国际放射医学核医学杂志,2016,40(1):35-43.DOI:10.3760/cma.j.issn.1673-4114.2016.01.008. Xu F,Liu JJ,Huang G,et al. The application of hypoxia imaging with PET in predicting tumor hypoxia and guiding clinical therapy[J].Int J Radiat Med Nucl Med,2016,40(1):35-43.DOI:10.3760/cma.j.issn.1673-4114.2016.01.008. [21]曹贵文,李学达,孙莉宁,等.125I放射性粒子植入对兔肝癌微血管密度及血管内皮生长因子的影响[J].当代医学,2011,17(5):108-112.DOI:10.3969/j.issn.1009-4393.2011.5.038. Cao GW,Li XD,Sun LN,et al. Effect of 125I radioactive particle on microvessel density and vascular endothelial growth factor in rabbit VX2 hepatic implantation tumor[J].Contemp Med,2011,17(5):108-112.DOI:10.3969/j.issn.1009-4393.2011.5.038. [22]苑陆杰,于华.125I粒子持续低剂量率照射杀伤恶性肿瘤作用机制研究进展[J].齐鲁医学杂志,2016,31(2):242-245.DOI:10.13362/j.qlyx.201602040. Yuan LJ,Yu ZH.Progress in the study of mechanisms of lethal and malignant tumor effects by irradiation with a sustained low dose rate of particles[J].Qilu Med J,2016,31(2):242-245.DOI:10.13362/j.qlyx.201602040. [23]Joiner MC,Marples B,Lambin P,et al. Low-dose hypersensitivity:current status and possible mechanisms[J].Int J Radiat Oncol Biol Phys,2001,49(2):379-389.DOI:10.1016/S0360-3016(00)01471-1.