AUTHOR=He Jian , Mai Qicong , Yang Fangfang , Zhuang Wenhang , Gou Qing , Zhou Zejian , Xu Rongde , Chen Xiaoming , Mo Zhiqiang 

TITLE=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

JOURNAL=Frontiers in Oncology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.627158

DOI=10.3389/fonc.2021.627158

ISSN=2234-943X

ABSTRACT=<p><bold>Objectives:</bold> To evaluate the feasibility and clinical value of CT-guided iodine-125 (<sup>125</sup>I) brachytherapy for pain palliation in patients with breast cancer and bone metastases after external beam radiotherapy failure.</p><p><bold>Methods:</bold> 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 <sup>125</sup>I brachytherapy and bisphosphonates (Group A), and 48 patients were treated with bisphosphonates alone (Group B).</p><p><bold>Results:</bold> In Group A, 45 <sup>125</sup>I brachytherapy procedures were performed in 42 patients with 69 bone metastases; the primary success rate of <sup>125</sup>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.</p><p><bold>Conclusion:</bold> The CT-guided <sup>125</sup>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.</p>