AI Article Synopsis
- This study investigates the use of iodine-125 seed implantation as a potential treatment for dysphagia in patients with advanced esophageal cancer, comparing its effectiveness to conventional chemoradiotherapy.
- Results show a significantly higher rate of dysphagia remission in the iodine-125 group compared to other treatment methods, particularly one month post-operation.
- Despite the effectiveness in improving swallowing, the overall survival rates were not significantly different between the iodine-125 group and certain chemotherapy groups, with no serious adverse events reported in the iodine-125 group.
Article Abstract
Background: The purpose of this study was to explore the feasibility, safety and efficacy of iodine-125 seed implantation in the treatment of dysphagia of advanced esophageal cancer.
Methods: We retrospectively analyzed patients with advanced esophageal cancer who underwent EUS-guided iodine-125 seed implantation or conventional chemoradiotherapy in our hospital. The propensity score match was used to reduce the baseline differences.
Results: A total of 127 patients were enrolled, 17 patients received EUS-guided iodine 125 seed implantation (Group A), 31 patients received radiotherapy (Group B), 38 patients received chemotherapy (Group C) and 41 patients received chemotherapy combined with radiotherapy (Group D). At half month postoperatively, the dysphagia remission rate in Group A (100%) was better than that in Groups B (39.3%), C (20%), D (15.8%), respectively, in the original cohort ( < 0.01); At 1 month postoperatively, the dysphagia remission rate in Group A (86.7%) was better than that in Group B (57.1%) ( > 0.05), Group C (25.7%) ( < 0.05) and Group D (34.2%) ( < 0.05), respectively, in the original cohort. There was no statistically significant difference in median overall survival (OS) between Group A (16 months) and Group B (37 months) ( = 0.149), and between Group A (16months) and Group C (16 months) ( = 0.918) in the original cohort. The mean OS of Group D (54 months) was better than that of Group A (20 months) in the original cohort ( = 0.031). The incidences of grade ≥2 myelosuppression in Groups B, C, and D were 12.9%, 28.9%, and 43.9%, respectively; the incidence of grade ≥2 gastrointestinal adverse events in Groups B, C, and D were 12.9%, 15.8%, 12.2%, respectively. No serious adverse events were found in Group A. The radiation dose around the patient was reduced to a safe range after the distance from the implantation site was more than 1 m (4.2 ± 2.6 μSv/h) or with lead clothing (0.1 ± 0.07 μSv/h).
Conclusions: Compared with conventional radiotherapy or chemotherapy alone, iodine-125 seed implantation might improve dysphagia more quickly and safely, further clinical data is needed to verify whether it could effectively prolong the OS of patients.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9793016 | PMC |
| http://dx.doi.org/10.1177/10732748221142946 | DOI Listing |
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