Preliminary experience of ¹²⁵I seed strands cavity brachytherapy for ureteral carcinoma

Objective: To evaluate the safety and efficacy of ¹²⁵I seed strands cavity brachytherapy for ureteral carcinoma. Methods: To tally 10 patients with ureteral carcinoma underwent C-arm CT and DSA guided percutaneous nephrostomy with ¹²⁵I seed strands cavity brachytherapy. The technical success rate, complications, tumor local control rate, ureteral patency and survival time, and compared the Karnofsky scores, Girignon grade, pain score before and after treatment were evaluated. The dose related parameters were compared between pre-and post-treatment. Results: ¹²⁵I seed strands implantation was successfully completed in all patients with technical success rate of 100%. The mean procedure time was (12.3 ± 3.8) min. No severe complications such as ureteral perforation, infection, severe bleeding occurred. Local tumor response was CR in 4 cases and PR in 6 cases, showing local control efficiency (CR + PR) 100% after 2-3 months. Ureteral patency rate was 50% (5/10). Postprocedure Karnofsky scores, Girignon grades, and pain scores were significantly improved (Z = -2.72, -2.88, -2.83, P < 0.01). The average follow-up time was (14.6 ± 6.5) months (5-25 months), tumor progression was observed in 3 cases, stable disease in 7 cases. Nine cases were alive and one died due to multiple organ failure. The differences of D_90%, mPD, V_100%, V_150%, V_200%, CI, EI, HI between the pre-and post-treatment were not statistically significant (P > 0.05). Conclusions: ¹²⁵I seed strands cavity brachytherapy for ureteral carcinoma is an effective and safe procedure without serious complications, and an effective alternative treatment for patients who are unable to undergoor refuse surgery. (authors)