¹²⁵I Intracavitary Irradiation Combined with ¹²⁵I Seeds Implantation for Treatment of Locally Advanced Pancreatic Head Cancer: A Retrospective Analysis of 67 Cases

Figures & data

Table 1 Basic Characteristics of Patients with Locally Advanced Pancreatic Head Carcinoma (n=67)

Variables	Overall	SEMS-CL-^125I Group (n=41)	Combined Group (n=26)	p value
Gender (male/female)	43/24	26/15	17/9	0.071
Age (years)	69.64±8.84	69.29±9.62	70.19±7.6	0.688
TBIL (µmol/L)	261.8 (78.3–424.2)	233.6 (78.3–424.2)	275 (225.7–356.9)	0.01
DBIL (µmol/L)	221.5 (58.3–343.1)	179.6 (58.3–343.1)	244.35 (191.3–299.8)	<0.001
ALT (U/L)	244 (33–432)	234 (33–432)	268.5 (129–420)	0.05
AST (U/L)	245 (46–239)	206 (46–342)	270 (179–394)	<0.001
ALP (U/L)	809 (216–1580)	749 (216–2556)	947.5 (490–1580)	0.005
ALB (g/L)	33.1 (23.4–44.8)	33.1 (25.3–44.8)	34 (23.4–42.7)	0.385
CEA (ng/mL)	12.58 (0.95–115.84)	8.38 (1.52–115.84)	16.43 (0.95–43.12)	0.008
CA19-9 (ng/mL)	875.9 (97.43–1997.4)	827.43 (123.14–1785.01)	1022.065 (97.43–1997.4)	0.700
CA-125 (ng/mL)	12.9 (5.4–392)	17.2(5.4–392)	10.8 (5.5–292.8)	0.236
Mean tumor diameter (mm)	39 (28–57)	38(28–55)	42 (34–57)	0.002
Cost (CNY)	43,821.48 (27,026.16–58,712.88)	40,135.07(27,026.16–58,712.88)	46,991.745 (42,104.95–52,829.58)	<0.001
Survival time (months)	11 (7–25)	9(7–21)	17 (9–25)	<0.001
Hospitalization period (months)	13 (7–18)	13(7–18)	12.5 (7–17)	0.529

Note: The bold part is P<0.05.

Abbreviations: TBIL, total bilirubin; DBIL, direct bilirubin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; ALP, alkaline phosphatase; ALB, albumin; CEA, carcinoembryonic antigen; CA19-9, carbohydrate antigen 19–9; CA-125, cancer antigen 125.

Figure 1 Comparison of liver function between the two groups (SEMS-CL-¹²⁵I and the combined group) before and after operation. Changes of (A) TBIL, (B) DBIL, (C) ALT, (D) AST, (E) ALP and (F) ALB at 1 month, 3 months and 6 months postoperatively (*p<0.05 compared with preoperative values in the SEMS-CL-¹²⁵I group; #p<0.05 compared with preoperative values in the combined group).

Table 2 Comparison of Pain Indexes (Based on VRS Scores) in the SEMS-CL-¹²⁵I Group and the Combined Group Preoperative and Postoperative

Group	Preoperative	Postoperative	Z Value	P value
SEMS-CL-^125I group (n=41)
Level 0	6	11	−5.477	<0.001
Level 1	12	24
Level 2	17	5
Level 3	6	1
Combined group (n=26)
Level 0	4	16	−4.334	<0.001
Level 1	9	7
Level 2	11	2
Level 3	2	1

Notes: Level 0, painless; Level 1, mild pain, tolerable, normal life and sleep; Level 2, moderate pain, significant pain, need to use analgesics, sleep disturbance; Level 3, severe pain, frequent use of analgesics, sleep seriously affected. The bold part is P<0.05.

Table 3 Imaging Assessment, Pain Index and Complications Related Information of Postoperative Patients

Characteristics	SEMS-CL-^125I Group (N=41)	Combined Group (N=26)	p value
Imaging assessment
CR	8	14	0.018
PR	23	8
NC	7	3
PD	3	1
Postoperative pain relief (3 months after surgery)
Level 0	11	16	0.035
Level 1	24	7
Level 2	5	2
Level 3	1	1
Complications
Biliary obstruction	4	2	0.601
P-tube shift	7	3
Biliary tract infection	1	0
Pancreatitis	1	0
Needle metastasize	0	1
Digestive discomfort	1	0

Notes: Level 0: no pain; Level 1: mild pain; Level 2: moderate pain; Level 3: severe pain. The bold part is P<0.05.

Abbreviations: CR, complete response; PR, partial response; NC, no change; PD, progressive disease.

Figure 2 CT images of the combined group and the SEMS-CL-¹²⁵I group preoperatively and 3 months postoperatively. (A and B) CT comparison between preoperative and postoperative reexaminations at 3 months in the SEMS-CL-¹²⁵I group. (C and D) CT comparison between preoperative and postoperative review at 3 months in the combined group (white and red arrows indicate the location of the tumor).

Figure 3 Kaplan–Meier cumulative survival curves detected the survival prognosis of the two groups. Compared with the SEMS-CL-¹²⁵I group, the combined group had a better survival prognosis. The median survival of the SEMS-CL-¹²⁵I group (9 months) was much lower than that of the combined group (17 months).