Efficacy of Permanent Iodine-125 Seed Implants and Gemcitabine Chemotherapy in Patients with Platinum-Resistant Recurrent Ovarian Carcinoma

Background: The aim of this study was to explore the efficacy and adverse reactions of CT-guided radioactive125I-seed implantation treatment combined with chemotherapy for platinum-resistant recurrent ovariancarcinoma. Materials and
Methods: From September 2010 to December 2012, 23 patients with platinum-resistantrecurrent ovarian carcinoma were enrolled. All the patients refused, could not bear, or were not suitable forsurgery. They all had no more than 3 lesions, which were detected and could also be measured by CT. All wereclarified as single-lesion or multiple-lesion groups. A total of 41 lesions underwent implantation of from 8 to106 125I seeds (median=43). Multi-plane implanting was adopted and 125I-seeds of (0.4-0.7)mCi were placedat intervals of (0.5-1.0) cm. After implantation treatment, all patients underwent 4 cycles of chemotherapy withgemcitabine 800 mg/m2 (days 1, 8 and 15).
Results: The outcome was evaluated with CT 3 weeks and every 3months after implantation treatment. After 6 months, the volume of 32 out of 41 lesions (78.0%) was reduced atleast 30%, within which 9 lesions completely disappeared(22.0%). Complete response was observed in 7 cases(30.4%), with a partial response in 4 cases (17.4%),4 cases stable(17.4%)and 8 cases showing progression (34.8%).The total clinical remission rate was 47.8% (11/23). The clinical remission rate was 77.8% (7/9) in the single-lesiongroup and 28.6% (4/14) in the multiple-lesion group with a significant difference between the two(P=0.036).The common side effects observed were mild gastrointestinal reactions.
Conclusions: 125I-seed implantationcombined with chemotherapy applies an effective way in the treatment of platinum-resistant recurrent ovarianepithelial carcinoma with the advantages of high local control rates, good short-term effects, little trauma andless side effects.