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Advances in Radiotherapy
& Nuclear Medicine 3D-PT-assisted CT-guided I RSI
125

confidence interval [CI]: 6.1 – 29.9 months). The local 5. Conclusion
control rates at 1, 2, 3, and 5 years were reported as 52%, 125
39%, 39%, and 39%, respectively, while the survival rates The efficacy and safety of CT-guided I RSI for managing
were 65%, 39%, 39%, and 39%, respectively, with a median recurrent HNC have been well established. The use of
125
survival time of 20 months (95% CI: 8.7 – 31.3 months). 3D-PTs to aid in the placement of I seeds effectively
In a follow-up long-term study, Jiang et al. investigated constrains the positioning and orientation of the needles
44
the efficacy and safety of CT-guided 125 I radioactive during interstitial treatment. This practice ensures
particle implantation as a salvage treatment following precise, controllable, and assessable needle insertion
external beam radiotherapy or surgery in 113 patients with by practitioners, thereby enhancing overall treatment
recurrent HNC. The median follow-up time for this study effectiveness and safety. This consensus document focuses
was 20 months, during which 87 patients passed away. on the workflow of 3D-PT for interstitial brachytherapy
The local control rates at 1, 2, 3, and 5 years were found using 125 I seed implantation to treat recurrent HNC. It
to be 57.4%, 41.8%, 29.3%, and 15.2%, respectively. The aims to promote the standardization of 3D-PT-assisted
median time to progression was 15 months (95% CI: 6.1 – CT-guided 125 I RSI brachytherapy in treating recurrent
23.9 months), and the median OS was 20 months (95% CI: HNC. This paper systematically summarizes the technical
12.4 – 27.6 months). The OS rates at 1, 2, 3, and 5 years were processes and standards for 125 I RSI assisted by 3D-PTs
63.6%, 44.6%, 29.9%, and 21.7%, respectively. Univariate for treating recurrent HNC. Its objective is to provide
and multivariate analyses showed that both the KPS score a comprehensive understanding of the indications and
and post-operative D90 were significantly correlated technical specifications for RSI while ensuring adherence
with patient OS. Complications primarily consisted of to standardized clinical practices among physicians,
Grade I/II skin and mucosal reactions: 18 cases (15.9%) medical physicists, therapists, and nurses.
experienced Grade I/II reactions, while eight cases (7.0%)
developed Grade III radiation dermatitis. In addition, Acknowledgments
14 cases (12.4%) exhibited Grade I/II mucosal reactions, None.
with only three cases (2.7%) reporting Grade III mucosal
reactions. No complications of Grade IV or higher severity Funding
were observed.
None.
In a separate retrospective study, Li et al. examined
47
33 cases of recurrent HNCs that had undergone two or Conflict of interest
more courses of radiotherapy. The LRC at 1 and 2 years Junjie Wang is the Editor-in-Chief, while Kaixian Zhang,
were found to be 47.8% and 36.4%, respectively, with a Ruoyu Wang and Zhe Wang are the Editorial Board
median LRC duration of 10 months. In addition, the OS Members of this journal and Guest Editors for this special
rates at 1 and 2 years were observed to be 41.3% and 32.2%, issue, but were not in any way involved in the editorial
respectively, with a median OS duration of 8 months. and peer-review process conducted for this paper, directly

The half-value layer of 125 I seeds is approximately or indirectly. Separately, other authors declared that they
0.025 mm Pb, and their half-life is around 60 days. After have no known competing financial interests or personal
this period, the energy decreases by half, and within relationships that could have influenced the work reported
6 months, it reduces to only 10% of its initial level. Beyond in this paper.
1 year, the radiation can be considered negligible. To
ensure safety, it is recommended to avoid contact with Author contributions
children and pregnant women for 2 months following seed Conceptualization: Zhe Ji, Yuliang Jiang, Suqing Tian,
implantation. For prolonged exposure (several hours or Kaixian Zhang, Ruoyu Wang, Zhe Wang, Junjie Wang
more), it is advised to maintain a distance of 1.5 – 2 cm or Writing – original draft: Qiman Han, Bin Qiu, Zhe Ji
recommended that patients wear lead necklaces, vests, and Writing – review & editing: Bin Qiu, Yi Chen, Junjie Wang
aprons made of lead for 2 months. Jiang et al. performed
24
3D-PNCT-assisted RSI in 42 patients with locally recurrent Ethics approval and consent to participate
malignant tumors of the head and neck, with a prescribed
dose ranging from 110 to 160 Gy. The median follow-up Not applicable.
time was 8.5 months. No cases experienced acute reactions Consent for publication
of grade ≥3, while three cases exhibited grade I skin
reactions. Not applicable.

Volume 2 Issue 4 (2024) 10 doi: 10.36922/arnm.4212