(125)I Intracavitary Irradiation Combined with (125)I Seeds Implantation for Treatment of Locally Advanced Pancreatic Head Cancer: A Retrospective Analysis of 67 Cases

BACKGROUND: Pancreatic cancer is an aggressive malignant tumor of the digestive system and the fourth leading cause of tumor-related death. Intracavitary (125)I seed irradiation has been recently developed as a therapy for locally advanced pancreatic head carcinoma. However, there are still many limitations, and more investigations are needed in order to optimize this new treatment method. METHODS: Sixty-seven patients were included in our study; 41 cases treated by SEMS-CL-(125)I intracavular irradiation (SEMS-CL-(125)I group) and 26 cases treated by SEMS-CL-(125)I intracavular irradiation combined with (125)I particle implantation in the tumor body (the combined group). Among the 67 patients, 43 were males and 24 were females, with an average age of 69.64±8.84 years. Tumor site size was determined based on the MRI or CT imaging scans, and the number and radius of (125)I particle placement were calculated according to a specific formula. (125)I particles were inserted into the tumor with a radius of 1.5 cm and a row spacing of 1 cm. The main postoperative biochemical indexes, imaging analysis, postoperative analgesia degree, median survival time and rate of complications were compared between the two groups. RESULTS: Jaundice and liver function improved in both groups after treatment for 6 months. The combined group did better. Kaplan–Meier analysis showed that patients in the combined group had a significantly better overall survival than those in the SEMS-CL-(125)I group. Patients in the combined group had less complications than those in the SEMS-CL-(125)I group (23.1% vs 34.1%), and the postoperative pain status of the combined group was improved (26.8% vs 53.8%). CONCLUSION: Compared with the SEMS-CL-(125)I intracavular irradiation alone, the combination of (125)I seed implantation with solid tumor (125)I seed implantation had a better therapeutic effect in LAPHC patients, with improved biochemical indicators, survival prognosis, pain relief, and fewer complications.