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Objectives:  To evaluate the feasibility and clinical value of CT-guided iodine-125 ( 125 I) brachytherapy for pain palliation in patients with breast cancer and bone metastases after external beam radiotherapy failure.   Methods:  From January 2014 to July 2016, a total of 90 patients, who had received the standard therapies for bone metastases but still suffered moderate-to-severe pain, were retrospectively studied. About 42 patients were treated with both  125 I brachytherapy and bisphosphonates (Group A), and 48 patients were treated with bisphosphonates alone (Group B).   Results:  In Group A, 45  125 I brachytherapy procedures were performed in 42 patients with 69 bone metastases; the primary success rate of  125 I seed implantation was 92.9%, without severe complications. Regarding pain progression of the two groups, Group A exhibited significant relief in “worst pain,” “least pain,” “average pain,” and “present pain” 3-day after treatment and could achieve a 12-week-remission for “worst pain,” “least pain,” “average pain,” and “present pain.” The morphine-equivalent 24-h analgesic dose at 3 days, 4 weeks, 8 weeks, and 12 weeks was 91 ± 27, 53 ± 13, 31 ± 17, and 34 ± 12 mg for Group A, and 129 ± 21, 61 ± 16, 53 ± 15, and 105 ± 23 mg for Group B. Group A experienced a lower incidence of analgesic-related adverse events and better quality of life than Group B.   Conclusion:  The CT-guided  125 I brachytherapy is a feasible and an effective treatment for the palliation of pain caused by bone metastases from breast cancer after external beam radiotherapy failure.

frontiers in oncology

Feasibility and Clinical Value of CT-Guided 125I Brachytherapy for Pain Palliation in Patients With Breast Cancer and Bone Metastases After External Beam Radiotherapy Failure