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Brachytherapy with iodine 125 seeds for bone metastases
Wei Wang1, Zhonghao Liu2, Jingrun Zhu3
1Department of Interventional Medicine, The Second Hospital of Shandong University; Department of Interventional Medicine, Intervention Research Institute, Shandong University, Jinan, Shandong Sheng, China.
Objective:
To evaluate the treatment safety and efficacy of iodine 125 (I125) seeds implantation in patients with bone metastases and assess the availability of quality of life (QOL) as an index for efficacy evaluation.
Patients And Methods:
The study enrolled 98 patients with 133 bone metastases from July 2010 to January 2016, who had undergone computed tomography-guided brachytherapy with I125 seeds. Brief pain inventory was administered to assess the degree of pain at the preoperative (W0) and postoperative 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 24 weeks (W2, W4, W8, W12, and W24). Drug use, QOL score, and complications were also assessed.
Results:
Postoperative pain scores were significantly decreased and maintained for a long term. Numerical rating scale score at W0 was 7.3 ± 1.6, which was decreased to 4.5 ± 1.7 (P < 0.01), 3.7 ± 1.3 (P < 0.01), 2.5 ± 1.1 (P < 0.01), 1.9 ± 0.9 (P < 0.01), and 1.3 ± 0.5 (P < 0.01) at W2, W4, W8, W12, and W24, respectively. After standardized transformation, the dose of morphine for patients at W0 was 175.2 ± 24.5 mg, which was decreased to 91.2 ± 21.7 mg (P < 0.01), 89.4 ± 24.6 mg (P < 0.01), 89.4 ± 24.6 mg (P < 0.01), 72.8 ± 14.8 mg (P < 0.01), and 56.7 ± 11.3 mg (P < 0.01) at W2, W4, W8, W12, and W24, respectively. The efficiency reached 65.3%, 85.1%, 91.2%, 95.2%, and 92.7% at postoperative W2, W4, W8, W12, and W24, respectively. QOL score at W0 was 17.4 ± 3.3, which increased to 23.2 ± 4.5 (P < 0.01), 28.6 ± 7.6 (P < 0.01), 43.2 ± 9.1 (P < 0.01), 45.6 ± 10.3 (P < 0.01), and 47.6 ± 9.8 (P < 0.01) at W2, W4, W8, W12, and W24, respectively.
Conclusion:
Brachytherapy with I125 seeds was safe and effective for treating bone metastases, offering a potential alternative to external-beam radiotherapy. QOL could be applied to evaluate the efficacy of I125 seeds implantation for treating bone metastases.
