Objective: To investigate the clinical value of CT guided radioactive seed (125)I implantation in treatment of pancreatic cancer.
Methods: Twenty-six patients with pancreatic cancer 6.1 cm in size on average, 21 males and 5 females, aged 60 +/- 13 (47 - 73), underwent CT guided radioactive seed (125)I implantation. Of the 26 patients 15 had the symptom of severer abdominal pain and 10 had jaundice. Three of them were in the TNM (pTNM) stage II, 30 in the stage III, and 3 in the stage IV. Treatment plan system was used to design the distribution of the seed (125)I needed. Under CT guidance, the (125)I seeds of (2.2 - 3.3) Mq were implanted into the pancreatic cancer at a distance of 1.0 - 1.5 cm. A follow-up for 3 - 12 months was conducted.
Results: Complete relief (CR) of the symptoms was seen in 9 patients, partial relief (PR) in 2 patients, and no change (NC) in 4 cases with an effective rate of 73.4%. The abdominal pain was relieved 3 - 7 days after the implantation. CT performed 2 months after implantation showed CR in 2 cases, PR in 13 cases, NC in 5 cases, and progression in 5 cases with an overall effective rate of 57.7%. Four patients died of local progression and 2 patients died of distant metastasis. Migration of the seeds into the liver was seen in 3 patients and slight decrease of white blood cells was seen in 1 patient during the 2-month follow-up. No severe complications, such as pancreatic leakage, acute pancreatitis, intestinal hemorrhage, etc, were found.
Conclusion: Safe and with minimal damage and few complications, CT guided radioactive seed (125)I implantation is effective in treatment of pancreatic cancer.