Ultrasound-guided percutaneous ¹²⁵I seed implantation for the treatment of osteolytic metastases: clinical analysis of 18 cases

Objective: To assess the effect of ultrasound-guided percutaneous ¹²⁵I seed implantation for the treatment of osteolytic metastases. Methods: From February 2011 to December 2013, a total of 18 patients with advanced cancer complicated by osteolytic metastases received ultrasound-guided percutaneous implantation of ¹²⁵I seeds. According to visual analog score (VAS) the pain was estimated before and 3 days as well as one month after the treatment. One month after the treatment follow-up CT scan was performed in all patients to check the tumor size and the distribution of ¹²⁵I seeds, and the therapy was repeated if necessary. The efficacy was evaluated according to Response Evaluation Criteria in Solid Tumors (RECIST). Results: A total of 33 times of procedure were carried out in the 18 patients. Three days after the treatment, local pain was obviously relieved in all cases. Compared with preoperative VAS, the postoperative VAS was significantly improved (P = 0.000). The pain was well controlled even one month after the treatment (P = 0.000). One month after the last treatment the complete remission (CR) rate was 0% (n = 0), partial remission (PR) rate 61.1% (n = 11), stable disease (SD) 33.3% (n = 6) and progress disease (PD) 5.6% (n = 1), and local control rate (CR + PR) was 61.1%. No severe brachytherapy-related complications occurred. Conclusion: Ultrasound-guided percutaneous ¹²⁵I seed implantation brachytherapy is technically simple and repeatable, it can safely and effectively guide the performance of percutaneous ¹²⁵I seed implantation for the treatment of osteolytic metastases. Even in the circumstance of not using TPS, this technique can also obtain satisfactory local control rate and significant pain relief. (authors)