Abstract:
Objective To investigate the safety and efficacy of 125I radioactive seed implantation in the treatment of mediastinal lymph node metastasis.
Methods Records of 53 patients enrolled in Shaanxi Provincial Tumor Hospital from June 2014 to June 2018 with mediastinal lymph node metastasis treated by computed tomography (CT)-guided 125I seed implantation were analyzed retrospectively. The preoperative treatment planning system was validated after the surgery. Intraoperative and post-operative complications were recorded. The improvement in quality of life was observed. Chest CT follow-up was conducted 1 month, 3 months, 6 months, 1 year, and 2 years after treatment. The local focus control was evaluated. The median survival and total survival were recorded, and the survival prognosis and causes of death were analyzed.
Results The median survival time was 254 days (8.5 months), one-year survival rate was 48.67%, and complete and partial response rate was 83.02% (44/53). Multivariate Cox model analysis showed that the survival prognosis was related to the Eastern Cooperative Oncology Group (ECOG) score, distant metastasis at the time of implantation, concurrent chemotherapy after implantation, and secondary seed implantation (P < 0.05). The rates of developing pneumothorax and hemoptysis during and after the surgery were 20.75% (11/55) and 13.20% (7/55), respectively. No patients died. After implantation, the remission rate of cough, shortness of breath, pain, hoarseness, and superior vena cava syndrome was 60.00%-82.61%.
Conclusions CT-guided 125I seed implantation in the treatment of mediastinal lymph node metastasis has the advantages of minimal trauma, remarkable curative effect, safety, and feasibility. It has important application value and is worthy of further clinical application.