Ultrasound-Guided Iodine-125 Seed Implantation for Cervical Metastatic Lymph Nodes: An Analysis of Efficacy and...

This study aimed to evaluate the efficacy and safety of ultrasound-guided radioactive iodine-125 (¹²⁵I) seed implantation as a local treatment for metastatic cervical lymph nodes.

We conducted a retrospective analysis of 29 patients (with a total of 53 metastatic lymph nodes) who underwent the procedure between January 2021 and December 2023. Under ultrasound guidance, ¹²⁵I seeds were percutaneously implanted according to a pre-planned dose distribution. Treatment response was assessed using contrast-enhanced CT at 3, 6, and 12 months post-implantation, based on RECIST 1.1 criteria. Overall survival was estimated using the Kaplan-Meier method.

All procedures were technically successful. Over a mean follow-up of 15 ± 10.5 months (range: 7-26). Local tumor control rates were 90.5%, 91.1%, and 75.9% at 3, 6, and 12 months, respectively. The 1-year and 2-year overall survival rates for patients were 55.2% and 37.9%; however, these results should be interpreted cautiously due to the small sample size and heterogeneity of primary tumors. The complication profile was favorable, with only one case (3.4%) of skin injury; other adverse events were minor and manageable.

Ultrasound-guided ¹²⁵I seed implantation is a feasible, safe, and effective local treatment option for metastatic cervical lymph nodes, offering high rates of local tumor control with minimal morbidity. It represents a valuable salvage or alternative therapy for this clinically challenging condition.