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Safety and efficacy of intraoperative iodine‐125 seed implantation brachytherapy for rectal cancer patients: A retrospective clinical research
Author(s) -
Luo YaJun,
Liu ZiLin,
Ye PengCheng,
Fu ZhiMing,
Lu Fei,
Suleiman Abdihakin Ali,
Liao Juan,
Xiao JiangWei
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13261
Subject(s) - medicine , brachytherapy , retrospective cohort study , colorectal cancer , surgery , radiology , general surgery , cancer , radiation therapy
Background: This pilot study was performed to evaluate the risk of anastomotic leakage (AL) and pelvic autonomic nerve dysfunction, and the effects of 125 I brachytherapy after intraoperative permanent implantation of iodine‐125 seeds within the patients with rectal carcinoma. Methods: In a cohort consisting of 80 rectal cancer patients who received potentially curative resection of rectal carcinoma with implantation of 125 I brachytherapy or radical resection of rectal carcinoma underwent total mesorectal excision. The incidences of AL, fecal incontinence, urinary dysfunction, and sexual dysfunction were calculated for comparison, and risk factors for these complications were analyzed by logistic regression. Rates of tumor recurrence and overall survival were evaluated. Results: Six out of 17 (35.29%) patients in the 125 I implant group and 1 out of 34 (2.94%) patients in the non‐implant group were complicated with AL ( P = 0.006). The incidences of urinary dysfunction ( P = 0.005) and fecal incontinence ( P = 0.023) were significantly different between the two groups. Multivariate analyses revealed that 125 I brachytherapy was an independent risk factor for AL (odds ratio, 18.702; 95%CI, 1.802–194.062; P = 0.014) and urinary dysfunction (odds ratio, 4.340; 95%CI, 1.158–16.264; P = 0.029), respectively. At postoperative 2‐year, the recurrence rates were 5.56% in the 125 I implant group and 9.09% in the non‐implant group ( P = 0.029). Conclusions: Intraoperative implantation of 125 I brachytherapy significantly increases the risk of AL, fecal incontinence, urinary dysfunction, and improves local control and do not improve overall survival after total mesorectal excision.