Development and preliminary clinical application of balloon-type iodine-125 particle catheters

This study aimed to design a multifunctional balloon catheter carrying radioactive iodine-125 (I-125) seeds for the treatment of patients with esophageal cancer with incomplete obstruction.

I-125 seeds were uniformly loaded into three microcatheters embedded in the balloon wall. The catheter was nasally inserted and positioned at the obstructive esophageal segment with digital subtraction angiography (DSA) guidance. The balloon was gradually inflated in accordance with tumor compression. Five patients were treated using this catheter, with documentation of placement success rate, procedural duration, and complications. In addition, DSA was performed biweekly to verify seed positioning. Swallowing was assessed at 2 months postprocedure using the Stooler grading system, along with contrast passage evaluation.

Successful placement was achieved in all five cases (100%), with a mean procedural time of 11 min. No significant complications (insertion difficulty, major bleeding, or chest pain) occurred intraoperatively. At the 2-month follow-up, all patients showed improved dysphagia (three cases: from Stooler grade 3 to grade 2; two cases: from Stooler grade 4 to grade 3), with confirmed contrast passage through the obstruction.

Results confirmed the safety and patient tolerance of the balloon-mounted I-125 seed catheter. This integrated device simultaneously provides enteral nutrition, localized brachytherapy, and mechanical dilation, representing a novel therapeutic approach for advanced esophageal cancer with incomplete obstruction.