Authors: Ping Jiang, Chen Liu, Junjie Wang, Ruijie Yang, Yuliang Jiang and Suqing Tian
Chest wall (CW) metastasis or recurrence are more common than primary CW tumors. Radical resection is in most cases the major component of treatment. Radiotherapy should be added when adequate margins cannot be achieved by surgery. Use of chemotherapy depends on primary tumor. While there are few data on the results of treatments on the patients with CW metastasis or recurrence, especially those with metastasectomy , radiotherapy and chemotherapy before. In many cases, there is no alternative. Managements of these patients remains challenging.
The interstitial implantation of 125I seeds, which is one of the most promising modalitiesof brachytherapy, has been successfully performed in many different malignant tumors during the past 20 years. The 125I seeds had a half-life(t1/2) of 59.4 days, a low X-ray energy level of 27.4–31.4KeV, and a half-value layer of 1.7 cm in tissue, giving a characteristic sharp dose drop-off . We have previous reported a series of results regarding 125I seeds implantation for pancreatic carcinoma, re-recurrent rectal cancer, recurrent head and neck carcinoma , and so on, in which the beneficial seed implantation characteristics of safety, sustained accumulation of radiation, and homogenous dose distribution in the target area were presented.
The aim of this study was to evaluate the efficacy and safety of 125I seed implantation for refractory CW metastasis or recurrence under CT guidance. In addition we assessed initial data obtained on the therapeutic response for refractory chest wall metastasis or recurrence.