Refractory nasopharyngeal carcinoma: Positron emission tomography combined with computed tomography-guided 125I seed implantation therapy after repeated traditional radiochemotherapy

摘要

Objective. To evaluate the feasibility of positron emission tomography combined with computed tomography (PET-CT)-guided 125I seed implantation in the treatment of patients with refractory nasopharyngeal carcinoma after repeated traditional radiochemotherapy. Study Design. Case series with chart review. Setting. University medical center. Subjects and Methods. A total of 26 patients (18 men, 8 women; mean age, 51.3 6 10.8 years; totaling 53 lesions with an average diameter of 2.86 6 1.61 cm) were treated by PET-CT-guided 125I seed implantation. All of the patients received a PET-CT scan 2 months after the treatment. Follow-up was conducted for ～2 to 43 months (median, 28.2 months) to observe the local control rate, overall survival rate, and clinical complications. Results. The local control rates of refractory nasopharyngeal carcinoma after repeated traditional radiochemotherapy after 3, 6, 12, 24, and 36 months were 90.6% (48/53), 79.3% (42/53), 71.7% (38/53), 62.3% (33/53), and 56.6% (30/53), respectively. The overall 1-, 2-, and 3-year survival rates were 87.2%, 71.3%, and 56.5%, respectively, with a median survival time of 28.2 months. Of all patients, 19.2% (5/26) died of local recurrence and 15.4% (4/26) died of metastases. One patient died of hypertensive cerebral hemorrhage, and another patient died from cachexia and infection. The long-term complications included hyperpigmentation at operative sites (n = 5), insensible feeling on the lateral cheek (n = 2), dryness of the oral cavity (n = 1), and headache (n = 1). Conclusion. PET-CT-guided 125I seed implantation is an acceptable and feasible method for treating refractory nasopharyngeal carcinoma with minimal damage and few complications.