A review on the efficacy and safety of iodine-125 seed implantation in unresectable pancreatic cancers

Abstract

Background: Pancreatic cancers are the common digestive system tumors with poor prognosis and due to its late diagnosis, surgical resection does not remain a viable treatment option in about 80% of patients. Amongst different treatment options, radioactive ¹²⁵I seed implantation therapy has also emerged as a good alternative in non-resectable pancreatic cancer patients.

Purpose: The present review describes the efficacy and safety of iodine-125 seed implantation in unresectable pancreatic cancers in preclinical and clinical studies.

Results: In this technique, small radioactive particles are implanted inside the tumor cells to produce the sustain effects. Due to the short radial distance of these radiations, there is a selective and efficient killing of cancer cells without any significant injury to the neighboring cells. Amongst the different methods for implanting ¹²⁵I seeds in the pancreatic tissues, CT scan or ultrasound-guided percutaneous seed implantation is preferred as it offers shorter operative time, lesser bleeding, early recovery, lesser complications, and low medical costs. The clinical studies have shown that radioactive ¹²⁵I seed implantation is a good option for the management of local tumor growth, pain palliation, and improvement in the life span of patients suffering from unresectable pancreatic cancer.

Conclusion: It may be employed either alone or in combination with cryotherapy, existing chemotherapy, bypass surgery or radiations to achieve the optimal results in these patients. Nevertheless, there is a need to formulate a uniform dose and procedure to achieve homogeneity and develop references for clinical practices.

Keywords:

• Radioactive iodine-125
• pancreatic cancer
• apoptosis
• chemotherapy
• brachytherapy

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Sheng-Nan Jia

Sheng-Nan Jia graduated from Jilin University with a master's degree. She is a hepatobiliary and pancreatic physician of the Second Hospital of Jilin University. Her research direction is hepatobiliary and pancreatic diseases.

Fu-Xing Wen

Fu-Xing Wen graduated from Qinghai University with a bachelor's degree and graduated from Jilin University with a master's degree. After graduation, he began to work as a physician in the Digestive Department in the Hospital of Jilin City Chemical Engineering. His research direction is the diagnosis and treatment of diseases of digestive system.

Ting-Ting Gong

Ting-Ting Gong graduated from Shanxi Medical University with a bachelor's degree and graduated from Jilin University with a master's degree. After graduation, she worked in the Department of Radiology of the Second Hospital of Jilin University. Her current research focuses on imaging diagnosis of celiac tumors.

Xin Li

Xin Li graduated from Jilin University with a master's degree. After graduation, she worked in the Department of Radiology of the Second Hospital of Jilin University. Her research direction is the MR imaging diagnosis of central nervous system and celiac tumor MRI diagnosis.

Hui-Jie Wang

Hui-Jie Wang graduated from Changchun University of Traditional Chinese Medicine with a bachelor's degree. She works in the Surgical Department of Gastrointestine and Nutrition of the Second Hospital of Jilin University. Her research direction is in nursing for general surgical diseases.

Ya-Min Sun

Ya-Min Sun graduated from Jilin University with a bachelor's degree. She works in the Surgical Department of Gastrointestine and Nutrition of the Second Hospital of Jilin University. Her research direction is in nursing for general surgical diseases.

Ze-Cheng Yang

Ze-Cheng Yang graduated from Jilin University with a doctoral degree. He works in the Surgical Department of Gastrointestine and Nutrition of the Second Hospital of Jilin University. His research direction is the diagnosis and treatment of general surgical diseases, especially the treatment of celiac tumors by I-125 seeds implantation and ablation.