CT-guided radioactive ¹²⁵I seed implantation for the treatment of mediastinal metastases: initial results in 11 patients

Objective: To discuss the technical method, safety and clinical efficacy of CT-guided ¹²⁵I radioactive seed implantation for the treatment of mediastinal lymph node metastases. Methods: CT-guided ¹²⁵I radioactive seed implantation was carried out in 11 patients with mediastinal lymph node metastases. Before ¹²⁵I seed implantation, the interstitial brachytherapy treatment planning system (TPS) was employed to formulate a treatment plan. The particles with radioactivity of (1.11-2.96) × 10⁷Bq (0.3-0.8 mCi) were used for the implantation. Postoperative complications were recorded. The local lesion control rate and the effective rate of pain relief were evaluated at one, 3, 6 and 12 months after ¹²⁵I seed implantation. Results: After ¹²⁵I seed implantation, pneumothorax occurred in 3 patients, tracheal fistula in one patient, and pulmonary infection in one patient. The local lesion control rates at one, 3, 6 and 12 months were 81.8%, 90.9%, 72.7% and 72.7% respectively; the effective rate of pain relief at one week, one, 3, 6 and 12 months were 100%, 90.9%, 90.9%, 81.8% and 72.7% respectively. Conclusion: For the treatment of mediastinal lymph node metastases, CT-guided radioactive ¹²⁵I seed implantation is less-invasive with less complications, and it carries reliable local lesion control rate. Therefore, this technique is a safe therapeutic means. (authors)