The Therapeutic Effect Of CT Guided Percutaneous Interstitial Implantation Of ¹²⁵? Seeds For Patients With Cervical Lymph Nodes Metastasis

Objective: To evaluate the therapeutic effect of CT guided percutaneous interstitial implantation of ¹²⁵? seeds for patients with cervical lymph nodes metastasis.Methods: From January 2010 to June 2012, 82 cases with cervical lymph nodes metastasis were divided into the ¹²⁵? implantation group and the conventional chemotherapy group according to the wishes of patients, the implantation group 48 cases,and the chemotherapy group 34 cases. The primary cancers derived from nasopharynx,esophagus, lingua, larynx, breast, lung, et al. The implantation group was treated with CT guided percutaneous interstitial implantation of ¹²⁵? seeds. The number of lymph nodes treated was 69. We employed computer TPS system to calculate seeds distribution. The seeds were implanted into the lesions under CT guided. CT examination after treatment for second and sixth months, the effect of treatment was evaluated according to the change of tumor volume.Results: CT examination after treatment for 2 months, in 69 lymph nodes metastasis,there were 40 complete relief?CR?, 17 partial relief?PR?; 10 no change?SD? and 2progression?PD?. The total effective power was 82.61%. CT examination after treatment for six months, 48 of 69 lymph nodes metastasis were complete relief?CR?, 11 partial relief?PR?; 7 no change?SD? and 3 progression?PD?. The total effective power was85.51%. Before operation the diameter of the CR and PR lymph nodes was 21.75±0.51 mm, 2 months after operation which reduced to 3.70±0.78 mm, and 6 months the diameter further reduced to 1.51±0.45 mm. There was a statistical difference between preoperative and postoperative at 2 or 6 months in the results of the diameter of the CR and PR lymph nodes?P<0.001?.In the conventional chemotherapy group 49 lymph nodes were observed.CT examination after chemotherapy for 2 months, in 49 lymph nodes metastasis, there were 4 complete relief?CR?, 7 partial relief?PR?; 30 no change?SD? and 8 progression?PD?. The total effective power was 22.45%. Before operation the diameter of the CR and PR lymph nodes was 26.91±1.71 mm, 2 months after operation which reduced to12.00±2.98 mm. After chemotherapy for 6 months, 2 of 49 lymph nodes metastasis were complete relief?CR?, 3 partial relief?PR?; 18 no change?SD? and 20 progression?PD?.The total effective power was 10.20%. The diameter of 49 SD and PD lymph nodes before chemotherapy, 24.48±0.64 mm, increased to 30.45±0.87 mm. The diameter of SD and PD lymph nodes at 2 or 6 months with distinctly significant change compared with that before chemotherapy?P<0.001?.Neither a case died nor a case suffered blood vessels embolism during follow up for 6months. Only 10 cases suffered from hypopigmentation during the first 6 months.8 cases suffered from swell during the first month at local skin, all of which recovered after symptomatic treatment.Conclusion: CT guided interstitial¹²⁵? seeds implantation is a safe, reliable, and effective curative method for the treatment of cervical lymph node metastasis in patients with carcinoma.