CT-guided seed implantation for the treatment of recurrent ovarian cancer

Objective: To discuss the feasibility, short-term efficacy and complications of CT-guided ¹²⁵I seed implantation in treating recurrent ovarian cancer. Methods: CT-guided ¹²⁵I seed implantation was carried out in 17 patients with recurrent ovarian cancer, which was clinically inoperable and failed to respond to conventional chemotherapy. A total of 19 lesions were detected in 17 patients. Before the treatment, a computerized treatment planning system (TPS) was used to work out the three-dimensional treatment scheme. Under CT guidance, ¹²⁵I seeds were implanted into the recurrent lesions. The therapeutic effects, quality of life and complications were evaluated. Results: Two months after the treatment, pelvic CT scanning was performed to evaluate the results. Of the 19 lesions, complete remission was obtained in 2, partial remission in 9, stable disease in 5 and progressive disease in 3. The total effective rate was 57.9% (11/19). Thirteen patients suffered from cancer pain, and the pain relief rate was 84.6% (11/13). After the treatment the general quality of live was dramatically improved when compared with the preoperative condition (P < 0.001). The median follow-up time was 10.5 months, ranging from 3 to 23 months. At the time of analysis twelve patients died, and the remaining five patients were still alive. The median progression free time was 6.4 months. The median overall survival time was 11.3 months and the one-year survival rate was 29.4%. The main adverse reactions observed in this series were very mild, and no severe complications such as intestinal fistula or treatment-related death occurred. Conclusion: In treating recurrent ovarian cancer, CT-guided ¹²⁵I seed implantation has excellent short-term effects with fewer complications although its long-term results need to be further studied. (authors)