CT-guidance interstitial 125 Iodine seed brachytherapy as a salvage therapy for recurrent spinal primary tumors
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RESEARCH
Open Access
CT-guidance interstitial 125Iodine seed brachytherapy as a salvage therapy for recurrent spinal primary tumors Qianqian Cao1, Hao Wang1, Na Meng1, Yuliang Jiang1, Ping Jiang1, Yang Gao1, Suqing Tian1, Chen Liu2, Ruijie Yang1, Junjie Wang1* and Kaixian Zhang3*
Abstract Background: Management of spinal neoplasms has relied on open surgery and external beam radiotherapy (EBRT). Although primary spinal tumors are rare, their treatment remains a pervasive problem. This analysis sought to evaluate the safety and efficacy of CT-guided 125I seed brachytherapy for recurrent paraspinous and vertebral primary tumors. Methods: From November 2002 to June 2014, 17 patients who met the inclusion criteria were retrospectively reviewed. 14 (82.4%) had previously undergone surgery, 15 (88.2%) had received conventional EBRT and 3 (17.6%) had chosen chemotherapy. The number of 125I seeds implanted ranged from 7 to 122 (median 79) with specific activity of 0.5-0.8 mCi (median 0.7 mCi). The post-plan showed that the actuarial D90 of 125I seeds were 90–183 Gy (median 137 Gy). The follow-up period ranged from 2 to 69 months (median 19 months). The local control rate was calculated by the Kaplan-Meier method. Results: For 5 Chondrosarcomas, the 1-, 2-, 3-year local control rates were 75%, 37.5%, and 37.5%, respectively, with a median of 34 months (range, 4–39 months). For 4 chordomas, the local control rate was 50% with a median follow-up of 13 months (range, 3–17 months). For 3 fibromatosis, all of them were survival without local recurrence at the end of follow-up. During the follow-up period, 35.3% (6/17) died from metastases, 17.6% (3/17) developed local recurrence by 8, 14 and 34 months while 64.7% (11/17) remained alive. 100% experienced pain relief and normal or improved ambulation, without more than Frankel grade 3 radiation myelopathy. Conclusions: Percutaneous primary tumors. Keywords: Brachytherapy,
125
125
I seed implantation can be an alternative or retreatment for recurrent spinal
I seed implantation, Primary spine tumors, CT-guided, Outcome
Background Primary spinal tumors which can be benign or malignant are relatively uncommon compared with metastases to the spine [1]. Common benign tumors in the spine include osteoid osteoma, osteoblastoma, aneurysmal bone cysts, osteochondroma and giant cell tumor. Malignant processes that can develop in the spine include multiple
* Correspondence: [email protected]; [email protected] 1 Department of Radiation Oncology, Cancer center, Peking University Third Hospital, No. 49 North Garden road, Haidian district, Beijing 100191, China 3 Cancer Center, Tengzhou Central People’s Hospital, Tengzhou city, Shangdong Province 277500, China Full list of author information is available at the end of the article
myeloma, osteosarcoma, chondrosarcoma, plasmacytoma and Ewing’s sarcoma. These various types of tumor result in a broad spectrum of symptoms ranging from backache to paraplegia. Initial presenting symptoms may include neural dysfunction, local pain
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