Interstitial brachytherapy of oral squamous cell carcinoma with ultrasound-guided iodine-125 radioactive seed implantation

Q. Tian, H.-H. Zhu, H. Li

Department of Ultrasonography, Henan Provincial People’s Hospital, Zhengzhou, Henan, China. tianqing2008@163.com

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• Oncology

OBJECTIVE: In this study, we investigated the clinical effect of interstitial brachytherapy on oral squamous cell carcinoma (OSCC) with ultrasound or CT-guided 125I radioactive seed implantation.

PATIENTS AND METHODS: 116 patients with advanced oral squamous cell carcinoma, who received initial treatment or retreatment, were enrolled. Therein, 35 patients in the control group were treated with external radiation, systemic chemotherapy or conservative treatment, 41 patients in the ultrasound group were treated with ultrasound-guided125I radioactive seed interstitial implantation brachytherapy, and 40 patients in the CT group were treated with CT-guided 125I radioactive seed interstitial implantation. The median follow-up time was 15.0 months. The clinical outcomes were compared.

RESULTS: At the time of one month after treatment, the tumor diameters of the ultrasound group and the CT group were significantly decreased (p<0.05), which were less than the control group (p<0.05), and there was no difference in comparison between the ultrasound group and the CT group (p>0.05). At the time of one month after treatment, the effective rates were significantly higher in the ultrasound group and the CT group than the control group (p<0.001), and there was no difference in comparison between the ultrasound group and the CT group. And there was no difference in comparison of complication between these two groups (p>0.05). At the time of one month after treatment, the VAS scores of pain were significantly lower in the ultrasound group and the CT group than the control group (p<0.05). There were no differences in comparisons of T lymphocyte subset percentages before and after treatment (p>0.05), and T lymphocyte subset percentages in the control group were significantly decreased (p<0.05). The progression-free survivals, median survival times, and survival rates were significantly higher in the ultrasound group and the CT group than those in the control group (p<0.05), and there were no differences in comparisons between the ultrasound group and the CT group (p>0.05).

CONCLUSIONS: Both ultrasound and CT-guided iodine-125 radioactive seed interstitial implantation brachytherapy in the treatment of OSCC  can achieve better short-term and long-term clinical effects.

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