Seed Implantation: Safe and Effective Salvage for HNC

May, 05, 2024 | Head & Neck Cancer

KEY TAKEAWAYS

  • The study aimed to evaluate the efficacy of 125I seed implantation in managing inoperable or declined surgery in patients with HNC.
  • The results revealed 125I seed implantation’s safety and efficacy as salvage therapy for inoperable or declined HNC.

Yuwei Zhang and the team aimed to assess the therapeutic impact of radioactive 125I seed implantation on head and neck cancer patients ineligible for or declining surgery.

The study retrospectively analyzed data from 132 patients with malignant head and neck tumors who underwent computed tomography-guided radioactive 125I seed implantation between April 2004 and August 2020. Local control and survival rates were calculated using the Kaplan-Meier method. Univariate analysis employed the logarithmic rank test, while multivariate analysis utilized the Cox proportional risk model.

Of 132 enrolled patients, all had pathologically confirmed malignant tumors. Seed implantation occurred at the primary tumor site (23 cases, 17.4%), recurrent tumors (9 cases, 6.8%), or metastatic lymph nodes (100 cases, 75.8%). At 3 months post-operation, 96 patients exhibited effectiveness, while 36 were deemed ineffective. Median local control time was 16 months, with local rates at 6, 12, 18, and 24 months observed at 75%, 47%, 35%, and 22% respectively.

Median overall survival (OS) was 15 months, with survival rates at 6, 12, 18, and 24 months noted at 61%, 42%, 31%, and 27% respectively. Skin or mucosal toxicity occurred in 14 patients, including grade I skin toxicity (7 cases, 5.3%), grade IV skin toxicity (1 case, 0.8%), grade I mucosal ulcer (4 cases, 3.0%), and grade I dry mouth (4 cases, 3.0%). Multivariate analysis identified short-term efficacy and tumor site as independent prognostic factors (P< 0.001, 0.006). Additionally, D90, longest tumor diameter, and short-term efficacy were independent OS influencing factors (P= 0.017, 0.001, <0.001, respectively).

The study concluded that radioactive 125I seed implantation represents a safe and effective salvage therapy for patients with inoperable or declined head and neck cancer surgery.

No financial support was provided.

Source: https://pubmed.ncbi.nlm.nih.gov/38687935/

Zhang Y, Liang Y, Liu Z, et al, (2024) “Efficacy of radioactive 125I seed implantation in treating inoperable or refused operation head and neck cancers.” J Cancer Res Ther. 2024 Apr 1;20(2):642-650. doi: 10.4103/jcrt.jcrt_1891_23. Epub 2024 Apr 30. PMID: 38687935.

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