CT-guided radioactive implant improves the outcomes of locally advanced rectal cancer

This study investigated the effectiveness and safety of computed tomography (CT)-guided radioactive ¹²⁵Iodine (RI) implantation in patients with recurrent locally advanced rectal cancer (LARC). Researchers suggested that CT-guided RI implantation is a good and safe treatment for patients with LARC that came back after previous treatment.

LARC that has been treated with surgery or radiotherapy commonly comes back at the same place after this first treatment. This is called local recurrence. Radiation therapy improves overall survival and progression in some of these patients. However, enough doses can hardly reach the recurrent tumor in the pelvis (the lower part of the abdomen) area. Moreover, standard radiation is associated with negative side effects.

CT-guided RI delivers a high dose of radiation without affecting the surrounding tissue. ¹²⁵Iodine provides a slow and continuous release of radiation to damage the tumor. The effectiveness of CT-guided RI implantation in patients with high-risk recurrent LARC is still not clear.

This study included information about 101 patients with LARC that came back after initial radiotherapy or surgery. All patients underwent RI implantation guided with CT imaging. The average follow-up time was 20.5 months.

Overall, 57.4% of patients responded to treatment. The average time cancer did not get worse was 10 months. The average overall survival was 20.8 months. 18.4% of patients had local control (the cancer did not worsen) at 5 years.

Side effects were observed in 13.9% of patients. Most of these were mild. 

This study concluded that CT-guided RI is a good and safe method for the treatment of LARC.

It was difficult to indicate if the cause for side effects was Iodine-125, disease progression, or previous high-doses of radiation. Moreover, this study is based on the medical records of a small number of patients. Some information might have been incomplete which can affect the results.