Feasibility and efficacy of endoscopic ultrasound-guided iodine-125 seed implantation in inoperable ampullary carcinoma: initial clinical experience

• Published in: Journal of contemporary brachytherapy Vol. 14; no. 3; pp. 233 - 240
• Main Authors: Cui, Tingting, Han, Lianqiang, Xiao, Nianjun, Liu, Fang, Li, Wen
• Format: Journal Article
• Language: English
• Published: Poznan Termedia Publishing House 01.01.2022
• Subjects: adenocarcinoma; ampullary; brachytherapy; Confidence intervals; endoscopic ultrasound; Endoscopy; Feasibility studies; Implantation; Iodine; Iodine 125; Iodine isotopes; Original Paper; Survival; Target detection; Tumors; Ultrasonic imaging
• DOI: 10.5114/jcb.2022.116121
• ISSN: 1689-832X

Purpose The objectives of the present study were to evaluate the feasibility, safety, and efficacy of endoscopic ultrasound (EUS)-guided iodine-125 (125I) seed implantation in ampullary carcinoma (AC). Material and methods From January 2011 to June 2020, 13 patients were selected for this retrospective study. Thirteen tumors (27.46 ±12.07 mm) were treated with EUS-guided 125I seed implantation in 29 sessions. We evaluated the therapeutic efficacy, adverse effects, and overall survival (OS) time. Results Complete response (CR) was observed in one tumor in 6 months. Partial response (PR) was detected in two target tumors in 3 months, seven in 6 months, seven in 9 months, and six in 12 months. Good periods of survival were observed. The median OS was 35 months, 95% confidence interval (95% CI) was 8.97 to 61.03 months. The 1-, 2-, and 5-year OS rates were 100%, 67.5%, and 11.3%, respectively. There were no procedure-related deaths or serious adverse events. Transient abdominal pain (5 cases, 17.2%), abdominal distension and loss of appetite (3 cases, 10.3%), and seed migration (1 case, 3.4%) were observed, respectively. Conclusions In selected patients with inoperable AC, EUS-guided 125I seed implantation is feasible and safe with favorable local control efficacy and OS.