Authors: Lei Lin, Junjie Wang, Yuliang Jiang, Na Meng, Su Qing Tian, Weiqiang Ran, Weiqiang Ran and Ruijie Yang
The aim of this study was to assess the outcomes of the patients and prognostic factors in management of cervical lymph node recurrence in esophageal carcinoma with percutaneous 125I seed implantation. Between March 2003 and December 2011, clinicopathological data of 21 patients, with 37 recurrent cervical lymph node metastases after radical treatment, who had undergone ultrasound-guided 125I seed implantation, were reviewed. The activity of the 125I seeds ranged from 0.5-0.8 mCi (median, 0.7 mCi). The total number of seeds implanted ranged from 9 to 98 (median, 43). The minimum dose delivered to 90% of the volume of interest (D90) was 123-204 Gy (median, 166 Gy). The median overall survival (OS) time was 7 months (95% CI, 5.3-7.7), and the 1- and 3-year survival rates were 23.8% and 4.8%, respectively. In univariate analysis, age, Karnofsky Performance Status (KPS), the number of recurrent nodes (a single node or multiple nodes), and the D90 were prognostic factors. Multivariate analysis demonstrated that the number of recurrent nodes was an independent prognostic factor for OS. Percutaneous 125I seed implantation is a safe and effective salvage treatment for esophageal carcinoma with recurrent cervical lymph node metastases after curative therapy, and the number of recurrent nodes was a prognostic factor.
Keywords: 125I seed implantation, recurrent lymph node metastases, esophageal carcinoma, outcome, prognosis