Effectiveness and security of CT-guided percutaneous implantation of 125I seeds in pancreatic carcinoma

Objective: To assess the effectiveness and security of CT-guided percutaneous implantation of iodine-125 (I-125)-labelled seeds in pancreatic carcinoma. Methods: A total of 36 patients (25 males and 11 females) with an average age of 57 years (range, 39-84 years) were enrolled and categorized into Stage III (27 cases) and Stage IV (9 cases) of pancreatic cancer. There were 3 tumours in the pancreatic head and 33 tumours in the pancreatic body or tail. The average diameter of the tumours was 37.1mm (range, 15-65mm). The implantation of I-125 seeds was performed by using 18-G needles (length, 150-200mm) through the anterior, lateral and posterior approaches. Then, I-125 seeds were loaded and released into the lesions. Results: Implantations were performed via the anterior (23 patients), lateral (9 patients) and posterior (4 patients) approaches. During implantation, 3-14 punctures were performed for each patient, and a total of 164 punctures were recorded. Meanwhile, a total of 657 seeds were implanted with an average of 25.27 (range, 12-50) seeds per patient, and the success rate was 100%. The activity of each seed ranged from 0.55 to 0.65 mCi. A main adverse event occurred in one puncture and minor events in seven punctures. No significant relationship between the punctures or adverse events was identified. No serious complication was detected after the implantations during follow-up visits. Conclusion: This study suggested that CT-guided percutaneous implantation of I-125 seeds in a pancreatic carcinoma was relatively safe and effective for treating unresectable pancreatic cancer.