科研之友
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摘要
Background: I-125 seed implantation is a new method in treatment of nasopharyngeal carcinoma (NPC), and it is worthwhile to evaluate its feasibility. In this study, we performed brachytherapy with computed tomography (CT)-guided permanent implantation of I-125 seeds in the treatment of patients with the recurrence of NPC. @@@ Methods: A total 30 patients (20 male and ten female) at the median age of 55 (range 25-80) years were diagnosed with recurrent nonkeratin NPC, with a total 38 lesions and a short disease-free interval (median similar to 11 months) after primary radiotherapy alone or combined with chemotherapy. Patients received CT scan, starting from 2 months after the treatment. Follow-up was conducted for similar to 2-38 months to observe the local control rate and overall survival rate. We also analyzed the possible correlation between survival periods and the status of recurrent tumors. @@@ Results: The local control rates at 6, 12, 24, 30, and 36 months after the procedure of I-125 seed implantation were 86.8%, 73.7%, 26.3%, 15.8%, and 5.3%, respectively. The overall 1-, 2-, and 3-year survival rates were 80.0% (24/30), 30.0% (9/30), and 6.7% (2/30), respectively, with a median survival period of 18 months (17.6 +/- 8.6 months). Interestingly, the survival periods of the patients who had primary radiotherapy with or without chemotherapy were 15.8 +/- 7.9 and 24.3 +/- 7.9 months, respectively. Kaplan-Meier survival analysis demonstrated that chi(2) (log rank) was 7.555, with very significant difference (P<0.01). The survival periods of patients in tumor stages I, II, III, and IV were 25.4 +/- 8.7, 19.8 +/- 9.4, 16.1 +/- 4.5, and 12.8 +/- 7.8 months, respectively, with significant differences (P<0.05). @@@ Conclusion: Our data suggest that the survival period of recurrent NPC patients after I-125 seed implantation is inversely related to the tumor stages of the recurrence but not to chemotherapy after the primary radiotherapy. Therefore, CT-guided I-125 seed implantation can be set for treatment of recurrent NPC, for better survival rate with minimal damage.
