Shi Shuyuan,Zheng Guangjun,Zhang Shengjie,Lyu Jinshuang,Feng Zhen,Chai Shude,Wang Junjie.CT guided coplanar template assisted in the treatment of metastatic or recurrent chest wall malignant tumor with 125Ⅰ seed implantation[J].Chinese Journal of Radiological Medicine and Protection,2017,37(7):539-542
CT guided coplanar template assisted in the treatment of metastatic or recurrent chest wall malignant tumor with 125Ⅰ seed implantation
Received:March 29, 2017  
DOI:10.3760/cma.j.issn.0254-5098.2017.07.013
KeyWords:Coplanar template  Radioactive seeds  Chest wall malignant tumor  Metastatic tumor  Recurrent tumor
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Author NameAffiliationE-mail
Shi Shuyuan Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Zheng Guangjun Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China xxwtj@sina.com 
Zhang Shengjie Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Lyu Jinshuang Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Feng Zhen Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Chai Shude Department of Thoracic Surgery, The Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Wang Junjie Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China  
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Abstract::
      Objective To evaluate the dosimetry accuracy and clinical efficacy of 125Ⅰ radioactive seed implantation using coplanar template (CPT) in the treatment of metastatic or recurrent chest wall tumor. Methods Thirty-one patients with metastasis or recurrence of chest wall tumor, who had been diagnosed with pathology between July 2005 and July 2015, were retrospectively studied. All patients underwent CPT-assisted 125Ⅰ radioactive seed implantation. Brachytherapy radiation treatment planning system (BTPS) was used to make preoperative plans, and the prescribed dose (PD) was 110 Gy. CPT was used to assist CT guided 125Ⅰ radioactive seeds implantation. Dose evaluation was performed immediately after implantation. The difference of dose parameters was compared between preoperation and postoperation, including D90, D100, V90, V100 and the numbers of seeds. Postoperative chest CT was conducted regularly to assess the treatment efficacy based on the response evaluation criteria in solid tumors (RECIST Version 1.1). The patients were followed up till July 2016. Results All patients went through implantation procedure successfully and there was no significant statistical difference between preoperative and postoperative dose parameters (P>0.05). The conformal index(CI) was 0.951±0.13,external index(EI) was 6.5%±0.9%. Six months after implantation, CR, PR, SD and PD were 25.8% (8/31), 51.6% (16/31), 6.5% (2/31) and 16.1% (5/31),respectively. The effective rate was 77.4%, and local control rate was 83.9% (26/31). Skin pigmentation occurred in 13 patients during the follow-up period, without any special treatment. Conclusions The auxiliary of CPT in the treatment of metastatic or recurrent chest wall tumor under the guiding of CT could achieve quality control, safety and effectiveness.
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