Background: Pancreatic cancer is an aggressive malignant tumor of the digestive system and the fourth leading cause of tumor-related death. Intracavitary ¹²⁵I seed irradiation has been recently developed as a therapy for locally advanced pancreatic head carcinoma. However, there are still many limitations, and more investigations are needed in order to optimize this new treatment method.
Methods: Sixty-seven patients were included in our study; 41 cases treated by SEMS-CL-¹²⁵I intracavular irradiation (SEMS-CL-¹²⁵I group) and 26 cases treated by SEMS-CL-¹²⁵I intracavular irradiation combined with ¹²⁵I particle implantation in the tumor body (the combined group). Among the 67 patients, 43 were males and 24 were females, with an average age of 69.64± 8.84 years. Tumor site size was determined based on the MRI or CT imaging scans, and the number and radius of ¹²⁵I particle placement were calculated according to a specific formula. ¹²⁵I particles were inserted into the tumor with a radius of 1.5 cm and a row spacing of 1 cm. The main postoperative biochemical indexes, imaging analysis, postoperative analgesia degree, median survival time and rate of complications were compared between the two groups.
Results: Jaundice and liver function improved in both groups after treatment for 6 months. The combined group did better. Kaplan–Meier analysis showed that patients in the combined group had a significantly better overall survival than those in the SEMS-CL-¹²⁵I group. Patients in the combined group had less complications than those in the SEMS-CL-¹²⁵I group (23.1% vs 34.1%), and the postoperative pain status of the combined group was improved (26.8% vs 53.8%).
Conclusion: Compared with the SEMS-CL-¹²⁵I intracavular irradiation alone, the combination of ¹²⁵I seed implantation with solid tumor ¹²⁵I seed implantation had a better therapeutic effect in LAPHC patients, with improved biochemical indicators, survival prognosis, pain relief, and fewer complications.
Keywords: locally advanced pancreatic cancer, ¹²⁵I, metal biliary stent