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

Tingting Cui; Lianqiang Han; Nianjun Xiao; Fang Liu; Wen Li

doi:10.5114/jcb.2022.116121

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

J Contemp Brachytherapy. 2022 Jun;14(3):233-240. doi: 10.5114/jcb.2022.116121. Epub 2022 May 10.

Authors

Tingting Cui^#^{1

2}, Lianqiang Han^#^{2

3}, Nianjun Xiao^{1

4}, Fang Liu², Wen Li²

Affiliations

¹ Department of Gastroenterology and Hepatology, Medical School of Chinese PLA, Beijing, China.
² Department of Gastroenterology and Hepatology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.
³ School of Medicine, Nankai University, Tianjin, China.
⁴ Department of Gastroenterology, Air Force Medical Center, Beijing, China.

^# Contributed equally.

Abstract

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.

Keywords: adenocarcinoma; ampullary; brachytherapy; endoscopic ultrasound.