CT-guided Radioactive 125I Seed Implantation for Abdominal Incision Metastases of Colorectal Cancer: Safety and Efficacy in 17 Patients

Abstract

Introduction: To retrospectively evaluate the safety and efficacy of computed tomography (CT)-guided iodine-125 (¹²⁵I) seed implantation for patients with abdominal incision metastases from colorectal cancer.

Materials and methods: Data of patients with abdominal incision metastases of colorectal cancer from November 2010 to October 2020 were retrospectively reviewed. Each incisional metastasis was percutaneously treated with ¹²⁵I seed implantation under CT guidance. Follow-up contrast-enhanced CT was reviewed, and the outcomes were evaluated in terms of objective response rate, complications, and overall survival.

Results: A total of 17 patients were enrolled in this study. The median follow-up was 18 months (range, 2.7-22.1 months). At 3, 6, 12, and 18 months after the treatment, objective response rate was 52.9%, 63.6%, 33.3%, and 0%, respectively. A small amount of local hematoma occurred in two patients and resolved spontaneously without any treatment. Two patients experienced a minor displacement of radioactive seeds with no related symptoms. Severe complications, such as massive bleeding and radiation injury, were not observed. No ≥ grade 3 adverse events were identified. By the end of follow-up, 14 patients died of multiple hematogenous metastases. The one-year overall survival rate was 41.6%, and the median overall survival was 8.6 months.

Conclusion: CT-guided ¹²⁵I seed implantation brachytherapy is safe and feasible for patients with abdominal incision metastases from colorectal cancer.

Keywords: Brachytherapy; Interventional radiology; Iodine-125 seed; Metastatic colorectal neoplasm; Radiotherapy.