To retrospectively evaluate effectiveness and safety of CT-guided 125I brachytherapy in patients with lung metastasis from hepatocellular carcinoma, sixty lung metastatic lesions in 29 patients were percutaneously treated in 34 125I brachytherapy sessions. Each metastatic lesion was treated with computed tomographic(CT) guidance. Follow-up contrast material-enhanced CT scans were reviewed and the efficacy of treatment was evaluated. Months are counted from the first time of 125I brachytherapy and the median duration of follow-up was 11 months (ranging from 6 - 17 months). The local control rates after 3, 6, 10 and 15 months were 86.2, 71.4, 60.9 and 50.0% respectively. At the time of writing, ten patients are alive without evidence of recurrence at 11 - 15 months. The 10 patients presented good control of local tumor and no systemic recurrence, and survived throughout the follow-up period. Other 11 patients died of multiple hematogenous metastases 5-15 months after brachytherapy. A small amount of local hematoma occurred in 5 patients that involved applicator insertion through the lung. Four patients presented pneumothorax with pulmonary compression of 30% - 40% after the procedure and recovered after drainage. Two patients had minor displacement of radioactive seeds. Severe complications such as massive bleeding and radiation pneumonitis did not occur. So CT-guided 125I brachytherapy is effective and may be safely applied to lung metastasis from hepatocellular carcinoma.
Cite this paper
Y. Chen, F. Gao, L. Chen, S. Peng, Y. Huang and Y. Wang, "Effectiveness and Safety of CT-Guided 125I Brachytherapy for Lung Metastasis from Hepatocellular Carcinoma," Open Journal of Radiology, Vol. 3 No. 3, 2013, pp. 159-164. doi: 10.4236/ojrad.2013.33026.
 H. S. Kim, J. W. Shin, G. Y. Kim, et al., “Metastasis of Hepatocellular Carcinoma to the Small Bowel Manifested by Intussusception,” World Journal of Gastroenterology, Vol. 12, No. 12, 2006, pp. 1969-1971.
 T. Nakashima, K. Okuda, M. Kojiro, et al., “Pathology of Hepatocellular Carcinoma in Japan. 232 Consecutive Cases Autopsied in Ten Years,” Cancer, Vol. 51, 1983, pp. 863-877.
 M. A. Bagshaw, R. S. Cox and J. E. Ramback, “Radiation Therapy for Localized Prostate Cancer. Justification by Long-Term Follow-Up,” Urologic Clinics of North America, Vol. 17, No. 4, 1990, pp. 787-802.
 F.-J. Zhang, P.-H. WU, Y.-K. GU, et al., “CT Guided Radioactive Seed 125I Implantation in Treating Lung Metastasis,” Chinese Journal of Radiology, Vol. 38, No. 9, 2004, pp. 906-909.
 X.-K. Hu, M.-Y. Wang, Z.-G. Yang, et al., “The Study of Curing Central-Type Lung Cancer by CT Guided Percutaneous Embedding of 125I Seeds,” Chinese Journal of Radiology, Vol. 38, No. 9, 2004, pp. 910-915.
 M. Johnson, A. Colonias, D. Parda, et al., “Dosimetric and Technical Aspects of Intraoperative I-125 Brachytherapy for Stage I Non-Small Cell Lung Cancer,” Physics in Medicine and Biology, Vol. 52, No. 2, 2007, pp. 1237-1245. doi:10.1088/0031-9155/52/5/002
 T. Peretz, D. Nori, B. Hilaris, et al., “Treatment of Primary Unresectable Carcinoma of the Pancreas with I-125 Implantation,” International Journal of Radiation Oncology, Biology, Physics, Vol. 17, No. 5, 1989, pp. 931935. doi:10.1016/0360-3016(89)90138-7
 F. J. Zhang, P. H. Wu, M. Zhao, et al., “CT Guided Radioactive Seed 125I Implantation in Treatment of Pancreatic Cancer,” Zhonghua Yi Xue Za Zhi, Vol. 86, 2006, pp. 223-227.
 S. Ebara, N. Katayama, R. Tanimoto, et al., “Iodine-125 Seed Implantation (Permanent Brachytherapy) for Clinically Localized Prostate Cancer,” Acta Medica Okayama, Vol. 62, No. 1, 2008, pp. 9-13.
 F.-J. Zhang, C.-X. Li, L. Zhang, et al., “Shortto Mid-Term Evaluation of CT-Guided 125I Brachytherapy on Intra-Hepatic Recurrent Tumors and/or Extra-Hepatic Metastases after Liver Transplantation for Hepatocellular Carcinoma,” Cancer Biology & Therapy, Vol. 8, No. 7, 2008, pp. 585-590.
 K. Uka, H. Aikata, S. Takaki, et al., “Clinical Features and Prognosis of Patients with Extrahepatic Metastases from Hepatocellular Carcinoma,” World Journal of Gastroenterology, Vol. 13, 2007, pp. 414-420.
 M. Natsuizaka, T. Omura, T. Akaike, et al., “Clinical Features of Hepatocellular Carcinoma with Extrahepatic Metastases,” Journal of Gastroenterology and Hepatology, Vol. 20, 2005, pp. 1781-1787.
 R. Nath, L. L. Anderson, G. Luxton, et al., “Dosimetry of Interstitial Brachytherapy Sources: Recommendations of the AAPM Radiation Committee Task Group No. 43,” Medical Physics, Vol. 22, No. 2, 1995, pp. 209-234.