Clinical value of 125I radioactive seed implantation in the treatment of lymph node metastasis of 131I refractory differentiated thyroid cancer

Zhang Wenwen; Lu Guoxiu; Shanhu Hao; Zhiguo Wang; Liqiu Ji; Xiangyan Ge; Gen Li; Youchao Wang; Guoxu Zhang

doi:10.1016/j.apradiso.2023.110868

Clinical value of ¹²⁵I radioactive seed implantation in the treatment of lymph node metastasis of ¹³¹I refractory differentiated thyroid cancer

Appl Radiat Isot. 2023 Sep:199:110868. doi: 10.1016/j.apradiso.2023.110868. Epub 2023 Jun 6.

Authors

Zhang Wenwen¹, Lu Guoxiu¹, Shanhu Hao¹, Zhiguo Wang¹, Liqiu Ji¹, Xiangyan Ge¹, Gen Li¹, Youchao Wang¹, Guoxu Zhang²

Affiliations

¹ Department of Nuclear Medicine, General Hospital of Northern Theater Command, No. 83, Wenhua Road, Shenhe District, Shenyang, 110016, Liaoning, China.
² Department of Nuclear Medicine, General Hospital of Northern Theater Command, No. 83, Wenhua Road, Shenhe District, Shenyang, 110016, Liaoning, China. Electronic address: zhangguoxu502@sina.com.

PMID: 37392614
DOI: 10.1016/j.apradiso.2023.110868

Abstract

Purpose: To evaluate the clinical value of ¹²⁵1 seed implantation in the treatment of lymph node metastasis of 111 cases of refractory differentiated thyroid cancer (RAIR-DTC).

Methods and materials: From January 2015 to June 2016, 42 patients with RAIR-DTC with lymph node metastasis (14 males and 28 females, median age 49 years) were analyzed retrospectively. After CT-guided ¹²⁵1 seed implantation, CT was reexamined 2,4,6 months after operation, and the changes of metastatic lymph node size, serum thyroglobulin (Tg) level and complications were compared before or after treatment. Paired-Samples T Test, Methods repetitive measure analysis of variance, Spearman correlation coefficient analysis were used to analyze the data.

Results: Among the 42 patients, 2 had complete remission (4.76%), 9 had partial remission (21.43%), 29 had no change (69.05%), and 2 had disease progression (4.76%), with an overall effective rate of 95.24% (40/42). The diameter of lymph node metastasis was (1.39 ± 0.75) cm after treatment and (1.99 ± 0.38) cm before treatment; the diameter of lymph node metastasis was significantly reduced after treatment compared with that before metastasis (t = 5.557, P< 0.01); the serum Tg at 2, 4 and 6 months after treatment were (53.34 ± 14.05) ug/L, (33.17 + 7.61)ug/L and (25.93 ± 10.91)ug/L, respectively, compared with (57.72 ± 15.23)ug/L before treatment, and the differences between serum Tg after treatment and before treatment were all statistically significant (F = 23.612,P<0.05). Except for the diameter of lymph node metastasis (χ² = 4.524, P<0.05), the patients' age, gender, metastasis site and the number of implanted particles per lesion were not influential factors in the efficacy (χ² = 0.569-15.884, r_s = 0.277, all P>0.05).

Conclusion: ¹²⁵I RSIT can significantly alleviate the clinical symptoms of RAIR-DTC patients with LNM, and the LNM lesions size has relevance for the treatment effect. The clinical follow-up time of serum Tg level can be extended to 6 months or even longer.

Keywords: Brachytherapy; Iodine radioisotope; Lymph nodes; Thyroid neoplasms; Tumor metastasis.

MeSH terms

Adenocarcinoma* / pathology
Female
Humans
Lymph Nodes / diagnostic imaging
Lymphatic Metastasis / pathology
Lymphatic Metastasis / radiotherapy
Male
Middle Aged
Retrospective Studies
Thyroid Neoplasms* / pathology
Thyroid Neoplasms* / radiotherapy

Substances

Iodine-131
Iodine-125