A pilot study of intraluminal brachytherapy using125 I seed strand for locally advanced pancreatic ductal adenocarcinoma with obstructive jaundice

Abstract Purpose To investigate the safety and feasibility of intraluminal brachytherapy using125 I seed strand for locally advanced pancreatic ductal adenocarcinoma with obstructive jaundice. Methods and Materials From January 2010 to February 2015, 18 consecutive patients diagnosed with locally advanced, nonmetastatic, inoperable pancreatic ductal adenocarcinoma with obstructive jaundice were enrolled and underwent intraluminal brachytherapy using125 I seed strand. Dose calculation was performed using a software. The procedure-related and radiation complications were assessed. Obstruction-free survival and overall survival were calculated using the Kaplan–Meier method. Results The technique successful rate of125 I seed strand implantation was 100%. Successful bile drainage was achieved in all patients. The estimated mean accumulating dose (R = 5 mm, z = 0, 240 days) was 167.2 Gy, from 164.19 to 170.05 Gy. Two patients had adverse event of Grade 3, one of Grade 4. Stent dysfunction occurred in 1/18 (5.6%) patients. The mean and median obstruction-free survival time were 10.61 months (95% confidence interval [CI]: 7.04, 14.18) and 7.26 months (95% CI: 2.14, 12.38). The mean and median overall survival time were 11.91 months (95% CI: 7.39, 16.43) and 7.26 months (95% CI: 2.14, 12.38). Conclusions Intraluminal brachytherapy using125 I seed strand may be consider as a safe treatment option for the therapy of locally advanced pancreatic duct adenocarcinoma complicated by obstructive jaundice with acceptable complication rates.