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BioMed Research International
Volume 2016, Article ID 8265907, 10 pages
http://dx.doi.org/10.1155/2016/8265907
Clinical Study

CT-Guided 125I Seed Interstitial Brachytherapy as a Salvage Treatment for Recurrent Spinal Metastases after External Beam Radiotherapy

1Department of Radiation Oncology, Peking University Third Hospital, Hua-Yuan North Road No. 49, Beijing 100191, China
2Cancer Center, The Second Hospital of Shandong University, Jinan, Shandong 250033, China
3Department of Nuclear Medicine, The First Affiliated Hospital of Wannan Medical College, No. 2 Zhe Shan Xi Road, Jinghu District, Wuhu 241001, China

Received 13 August 2016; Revised 30 October 2016; Accepted 29 November 2016

Academic Editor: Yujiang Fang

Copyright © 2016 Lihong Yao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The aim of this study is to evaluate the feasibility, safety, and clinical efficacy of CT-guided 125I seed interstitial brachytherapy in patients with recurrent spinal metastases after external beam radiotherapy (EBRT). Between August 2003 and September 2015, 26 spinal metastatic lesions (24 patients) were reirradiated by this salvage therapy modality. Treatment for all patients was preplanned using a three-dimensional treatment planning system 3–5 days before 125I seed interstitial brachytherapy; dosimetry verification was performed immediately after seed implantation. Median actual was 99 Gy (range, 90–176), and spinal cord median was 39 Gy (range, 6–110). Median local control (LC) was 12 months (95% CI: 7.0–17.0). The 6- and 12-month LC rates were 52% and 40%, respectively. Median overall survival (OS) was 11 months (95% CI: 7.7–14.3); 6-month and 1-, 2-, and 3-year OS rates were 65%, 37%, 14%, and 9%, respectively. Pain-free survival ranged from 2 to 42 months (median, 6; 95% CI: 4.6–7.4). Treatment was well-tolerated, with no radiation-induced vertebral compression fractures or myelopathy reported. Reirradiation with CT-guided 125I seed interstitial brachytherapy appears to be feasible, safe, and effective as pain relief or salvage treatment for patients with recurrent spinal metastases after EBRT.