Radioactive <sup>125</sup>I seed implantation in the treatment of unresectable pancreatic cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YE Jun , YANG Dujiang , LI Zhenlu , LU Huimin ,  HU Weiming

Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

HU Weiming, Email: huweiming@scu.edu.cn

Keywords：

pancreatic cancer; radioactive ¹²⁵I seed; implantation therapy; complication; review

DOI：

10.7507/1007-9424.201904013

Video：

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Objective To investigate the current status and research progress of radioactive ¹²⁵I seed implantation in the treatment of unresectable pancreatic cancer.Methods Reviewed the relevant literatures to summarize and analyze the mechanism of action, indications and contraindications, implantation methods, clinical efficacy, complications, and treatment measures of radioactive ¹²⁵I seed implantation in the treatment of pancreatic cancer.Results The mechanism of radioactive ¹²⁵I seed implantation in the treatment of pancreatic cancer had been deeply studied in terms of gene expression and molecular signal level. The procedure was applicable to a wide range of patients; the implantation methods were abundant, CT and ultrasound guidance had their advantages; it could effectively inhibit tumor growth and improve overall survival rate. It was dramatically for pain relief, as well as low overall complication rate, and the complications could be alleviated by symptomatic treatment.Conclusion Radioactive ¹²⁵I seed implantation in the treatment of unresectable pancreatic cancer has been widely promoted due to its simple operation and small trauma, and it is effective in controlling tumor growth, prolonging survival, and relieving pain.

Citation： YE Jun, YANG Dujiang, LI Zhenlu, LU Huimin, HU Weiming. Radioactive ¹²⁵I seed implantation in the treatment of unresectable pancreatic cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(11): 1378-1384. doi: 10.7507/1007-9424.201904013 Copy

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2.	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
3.	Balaban EP, Mangu PB, Khorana AA, et al. Locally advanced, unresectable pancreatic cancer: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol, 2016, 34(22): 2654-2668.
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5.	D’Angio G, Hilaris BS, Arthur K, et al. Iodine 125 implantation for unresectable cancer of the pancreas. Postgrad Med, 1970, 47(3): 226-230.
6.	苑陸杰, 于華. (125) I 粒子持續低劑量率照射殺傷惡性腫瘤作用機制研究進展. 齊魯醫學雜志, 2016, 31(2): 242-245.
7.	Du YQ, Li ZS, Jin ZD. Endoscope-assisted brachytherapy for pancreatic cancer: from tumor killing to pain relief and drainage. J Interv Gastroenterol, 2011, 1(1): 23-27.
8.	Hu Y, Qi E, Liu F, et al. The application of a three-dimensional visualized seed planning and navigation system in ¹²⁵I seed implantation for pancreatic cancer. Onco Targets Ther, 2018, 11: 619-627.
9.	Kim SY, Yang ES, Lee YS, et al. Sensitive to apoptosis gene protein regulates ionizing radiation-induced apoptosis. Biochimie, 2011, 93(2): 269-276.
10.	Colmenares R, Krupa K, Mu?oz A, et al. A process to describe radiation damage at the molecular level. Application to the ¹²⁵I seeds in water. Appl Radiat Isot, 2018, 140: 163-170.
11.	Yang Y, Xie Q, Zhao Z, et al. Functionalized selenium nanosystem as radiation sensitizer of ¹²⁵I seeds for precise cancer therapy. ACS Appl Mater Interfaces, 2017, 9(31): 25857-25869.
12.	Wang J, Wang J, Liao A, et al. The direct biologic effects of radioactive ¹²⁵I seeds on pancreatic cancer cells PANC-1, at continuous low-dose rates. Cancer Biother Radiopharm, 2009, 24(4): 409-416.
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1. Zheng J, Guinter MA, Merchant AT, et al. Dietary patterns and risk of pancreatic cancer: a systematic review. Nutr Rev, 2017, 75(11): 883-908.
2. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
3. Balaban EP, Mangu PB, Khorana AA, et al. Locally advanced, unresectable pancreatic cancer: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol, 2016, 34(22): 2654-2668.
4. Cameron JL, He J. Two thousand consecutive pancreatico- duodenectomies. J Am Coll Surg, 2015, 220(4): 530-536.
5. D’Angio G, Hilaris BS, Arthur K, et al. Iodine 125 implantation for unresectable cancer of the pancreas. Postgrad Med, 1970, 47(3): 226-230.
6. 苑陸杰, 于華. (125) I 粒子持續低劑量率照射殺傷惡性腫瘤作用機制研究進展. 齊魯醫學雜志, 2016, 31(2): 242-245.
7. Du YQ, Li ZS, Jin ZD. Endoscope-assisted brachytherapy for pancreatic cancer: from tumor killing to pain relief and drainage. J Interv Gastroenterol, 2011, 1(1): 23-27.
8. Hu Y, Qi E, Liu F, et al. The application of a three-dimensional visualized seed planning and navigation system in ¹²⁵I seed implantation for pancreatic cancer. Onco Targets Ther, 2018, 11: 619-627.
9. Kim SY, Yang ES, Lee YS, et al. Sensitive to apoptosis gene protein regulates ionizing radiation-induced apoptosis. Biochimie, 2011, 93(2): 269-276.
10. Colmenares R, Krupa K, Mu?oz A, et al. A process to describe radiation damage at the molecular level. Application to the ¹²⁵I seeds in water. Appl Radiat Isot, 2018, 140: 163-170.
11. Yang Y, Xie Q, Zhao Z, et al. Functionalized selenium nanosystem as radiation sensitizer of ¹²⁵I seeds for precise cancer therapy. ACS Appl Mater Interfaces, 2017, 9(31): 25857-25869.
12. Wang J, Wang J, Liao A, et al. The direct biologic effects of radioactive ¹²⁵I seeds on pancreatic cancer cells PANC-1, at continuous low-dose rates. Cancer Biother Radiopharm, 2009, 24(4): 409-416.
13. Li D, Jia YM, Cao PK, et al. Combined effect of (125)I and gemcitabine on PANC-1 cells: cellular apoptosis and cell cycle arrest. J Cancer Res Ther, 2018, 14(7): 1476-1481.
14. Wang ZM, Lu J, Zhang LY, et al. Biological effects of low-dose-rate irradiation of pancreatic carcinoma cells in vitro using ¹²⁵I seeds. World J Gastroenterol, 2015, 21(8): 2336-2342.
15. Liu C, Wang L, Qiu H, et al. Combined strategy of radioactive ¹²⁵I seeds and salinomycin for enhanced glioma chemo-radiotherapy: evidences for ROS-mediated apoptosis and signaling crosstalk. Neurochem Res, 2018, 43(7): 1317-1327.
16. Gao J, Wang L, Xu J, et al. Aberrant DNA methyltransferase expression in pancreatic ductal adenocarcinoma development and progression. J Exp Clin Cancer Res, 2013, 32: 86.
17. Ma JX, Jin ZD, Si PR, et al. Continuous and low-energy ¹²⁵I seed irradiation changes DNA methyltransferases expression patterns and inhibits pancreatic cancer tumor growth. J Exp Clin Cancer Res, 2011, 30: 35.
18. Bapat AA, Hostetter G, Von Hoff DD, et al. Perineural invasion and associated pain in pancreatic cancer. Nat Rev Cancer, 2011, 11(10): 695-707.
19. Xu Q, Wang Z, Chen X, et al. Stromal-derived factor-1α/CXCL12-CXCR4 chemotactic pathway promotes perineural invasion in pancreatic cancer. Oncotarget, 2015, 6(7): 4717-4732.
20. Alrawashdeh W, Jones R, Dumartin L, et al. Perineural invasion in pancreatic cancer: proteomic analysis and in vitro modelling. Mol Oncol, 2019, 13(5): 1075-1091.
21. Lu Z, Dong TH, Si PR, et al. Continuous low-dose-rate irradiation of Iodine-125 seeds inhibiting perineural invasion in pancreatic cancer. Chin Med J (Engl), 2016, 129(20): 2460-2468.
22. Morganti AG, Trodella L, Valentini V, et al. Pain relief with short-term irradiation in locally advanced carcinoma of the pancreas. J Palliat Care, 2003, 19(4): 258-262.
23. Yang Y, Ma ZH, Li XG, et al. Iodine-125 irradiation inhibits invasion of gastric cancer cells by reactivating microRNA-181c expression. Oncol Lett, 2016, 12(4): 2789-2795.
24. Bapat AA, Munoz RM, Von Hoff DD, et al. Blocking nerve growth factor signaling reduces the neural invasion potential of pancreatic cancer cells. PLoS One, 2016, 11(10): e0165586.
25. Nagasawa H, Little JB. Induction of sister chromatid exchanges by extremely low doses of alpha-particles. Cancer Res, 1992, 52(22): 6394-6396.
26. Widel M. Radionuclides in radiation-induced bystander effect; may it share in radionuclide therapy? Neoplasma, 2017, 64(4): 641-654.
27. Turchan WT, Shapiro RH, Sevigny GV, et al. Irradiated human endothelial progenitor cells induce bystander killing in human non-small cell lung and pancreatic cancer cells. Int J Radiat Biol, 2016, 92(8): 427-433.
28. 蓋保東, 肖中迪, 劉晶, 等. ¹²⁵Ⅰ放射性粒子治療不同分期胰腺癌. 內分泌外科雜志, 2008, 2(4): 246-248.
29. 中國抗癌協會胰腺癌專業委員會. 胰腺癌綜合診治指南(2018版). 中華外科雜志, 2018, 56(7): 481-494.
30. Wang J, Chai S, Zheng G, et al. Expert consensus statement on computed tomography-guided (125)I radioactive seeds permanent interstitial brachytherapy. J Cancer Res Ther, 2018, 14(1): 12-17.
31. Wang J, Jiang Y, Li J, et al. Intraoperative ultrasound-guided iodine-125 seed implantation for unresectable pancreatic carcinoma. J Exp Clin Cancer Res, 2009, 28: 88.
32. Wang H, Wang J, Jiang Y, et al. The investigation of ¹²⁵I seed implantation as a salvage modality for unresectable pancreatic carcinoma. J Exp Clin Cancer Res, 2013, 32: 106.
33. Li YF, Liu ZQ, Zhang YS, et al. Implantation of radioactive (125)I seeds improves the prognosis of locally advanced pancreatic cancer patients: a retrospective study. J Huazhong Univ Sci Technolog Med Sci, 2016, 36(2): 205-210.
34. Zheng Z, Xu Y, Zhang S, et al. Surgical bypass and permanent iodine-125 seed implantation vs. surgical bypass for the treatment of pancreatic head cancer. Oncol Lett, 2017, 14(3): 2838-2844.
35. Liu K, Ji B, Zhang W, et al. Comparison of iodine-125 seed implantation and pancreaticoduodenectomy in the treatment of pancreatic cancer. Int J Med Sci, 2014, 11(9): 893-896.
36. Liu Y, Lyu SC, Wang XQ, et al. Application of preoperative three-dimensional model design in radioactive particle implantation for advanced pancreatic cancer. Onco Targets Ther, 2018, 11: 8685-8693.
37. 李清春, 楊文濤, 蓋保東, 等. 放射性碘-125 粒子植入治療腹腔腫瘤的徒手穿刺技巧. 中國普外基礎與臨床雜志, 2018, 25(12): 1507-1510.
38. Xu K, Niu L, Mu F, et al. Cryosurgery in combination with brachytherapy of iodine-125 seeds for pancreatic cancer. Gland Surg, 2013, 2(2): 91-99.
39. Zhongmin W, Yu L, Fenju L, et al. Clinical efficacy of CT-guided iodine-125 seed implantation therapy in patients with advanced pancreatic cancer. Eur Radiol, 2010, 20(7): 1786-1791.
40. 俞炎平, 江海濤, 姚征, 等. CT 引導下經皮胰腺穿刺活檢和組織間植入治療的徑路及安全性. 中華腫瘤雜志, 2013, 35(8): 608-612.
41. Yu YP, Yu Q, Guo JM, et al. Effectiveness and security of CT-guided percutaneous implantation of (125)I seeds in pancreatic carcinoma. Br J Radiol, 2014, 87(1039): 20130642.
42. Wang B, Hao Y, Pu F, et al. Computer-aided designed, three dimensional-printed hemipelvic prosthesis for peri-acetabular malignant bone tumour. Int Orthop, 2018, 42(3): 687-694.
43. Zeng H, Yuan-Liang S, Xie G, et al. Three-dimensional printing of facial contour based on preoperative computer simulation and its clinical application. Medicine (Baltimore), 2019, 98(2): e12919.
44. Rynio P, Kazimierczak A, Jedrzejczak T, et al. A 3D printed aortic arch template to facilitate decision-making regarding the use of an externalized transapical wire during thoracic endovascular aneurysm repair. Ann Vasc Surg, 2019, 54: 336. e5-336. e8.
45. 吉喆, 姜玉良, 郭福新, 等. 3D 打印模板聯合 CT 引導下放射性粒子植入治療椎旁/腹膜后惡性腫瘤的劑量學驗證觀察. 中華醫學雜志, 2017, 97(13): 996-1000.
46. Huang W, Lu J, Chen KM, et al. Preliminary application of 3D-printed coplanar template for iodine-125 seed implantation therapy in patients with advanced pancreatic cancer. World J Gastroenterol, 2018, 24(46): 5280-5287.
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Radioactive ¹²⁵I seed implantation in the treatment of unresectable pancreatic cancer

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Radioactive 125I seed implantation in the treatment of unresectable pancreatic cancer

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Radioactive ¹²⁵I seed implantation in the treatment of unresectable pancreatic cancer