Clinical efficacy of computed tomography-guided iodine-125 seed implantation therapy in patients with advanced spinal metastatic tumors

OBJECTIVE The purpose of this study was to examine the safety and clinical efficacy of computed tomography (CT)-guided radioactive iodine-125 ((125)I) seed implantation treatment in patients with spinal metastatic tumors. METHODS We retrospectively analyzed 20 cases of spinal metastatic tumors, including nine men and eleven women aged 50-79 years (mean age: 61.1 years). We used treatment planning system (TPS) to construct three-dimensional images of the spinal metastatic tumors and to determine what number and dose rate distribution to use for the (125)I seeds. The matched peripheral dose of the (125)I seed implantation was 90-130 Gy. Twenty-four spinal metastatic tumors were treated by CT-guided radioactive (125)I seed implantation. A median of 19 (range: 4-43) (125)I seeds were implanted. RESULTS Twenty cases were followed for a median of 15.3 months (range: 7-32 months). The rate of pain relief was 95%. The median control time for all of the patients was 12.5 months. The 3-, 6-, and 12-month cumulative local control rates were 100%, 95%, and 60%, respectively. The median survival time for all of the patients was 16 months. The cumulative 6- and 12-month survival rates were 100% and 78.81%, respectively. No major complications were observed. No (125)I seeds were lost or migrated to other tissues or organs. CONCLUSION CT-guided radioactive (125)I seed implantation is a safe, effective, and minimally invasive method for the treatment of patients with spinal metastatic tumors. It is a possible alternative therapy for the treatment of spinal metastases.