The Efficacy And Safety Of ¹²⁵I Seed Implantation On The Treatment Of Radioiodine-refractory Thyroid Carcinoma

Objective:To retrospectively analyze the efficacy and safety of ¹²⁵I seed implantation in the treatment of radioiodine-refractory differentiated thyroid carcinoma（RAIR-DTC）,in order to provide a theoretical basis for clinical treatment.Methods:14 patients with RAIR-DTC who underwent ¹²⁵I seed implantation in Hebei Provincial People’s Hospital from March 2013 to June2018 were enrolled,including 13 cases of cervical metastases and 1 case of lung metastasis.All patients underwent CT or ultrasound-guided implantation of ¹²⁵I seeds with an activity of 0.3-0.8mCi.The prescription dose for cervical metastatic cancer were 90-120 Gy,and for lung metastases was 140 Gy.The tumor control,patient survival,symptom relief,and adverse reactions were observed.Results:All patients were followed up for 10-96 months（median time 36months）.Two months after treatment,complete remission was in 1 patient,partial remission was in 11,and disease stability was in 2,no patient with progression;the effective rates at 6,12,24,and 36 months after treatment were 85.7%,57.9%,42.8%and 28.5%,respectively.The local control time was 8-72 months（the median time was 24 months）,the local control rates at 6,12,24,and 36 months after treatment were 100%,78.5%,57.1%and 28.5%,respectively;median survival time was 60 months（95%CI:34.2-85.7months）.The cumulative survival rates at 1,2 and 5 years after treatment were100%,100%and 40%,respectively.Preoperative pain score of the 7 patients was 4.14±1.68,and the score was 2.00±1.15（P<0.05）at 2 months after treatment.3 patients had preoperative airway stenosis with a minimum diameter of 1.06±0.20cm.After 2 months,the minimum diameter of the airway was 1.58±0.27cm（P<0.05）.3 cases of grade I radiation skin lesions were found without special treatment.1 case of pneumothorax,lung pressure<20%,improved after puncture and pumping.No patient had bleeding,radiation pneumonitis or esophagitis,air embolism,and treatment-related death.Conclusions:1.¹²⁵I seed implantation for RAIR-DTC has better curative effect and乐less adverse reactions,which can improve the local control rate of tumor.2.¹²⁵I seed implantation can alleviate the pain and airway obstruction caused by local tumors.3.¹²⁵I seed implantation for RAIR-DTC cervical metastatic cancer patients with a dose of 90-120Gy,may get better local control.