Journal of Contemporary Brachytherapy最新文献

{"title":"Impact of patient transfer system on applicator stability and dosimetry in cervical cancer brachytherapy.","authors":"Jittima Junhong, Ekkasit Tharavichitkul, Anirut Watcharawipha, Somsak Wanwilairat, Wannapha Nobnop","doi":"10.5114/jcb.2025.152541","DOIUrl":"10.5114/jcb.2025.152541","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate applicator displacement due to patient transfer using traditional fixation (TRD) with and without patient transfer system (TS), and to assess its dosimetric impact on organs at risk (OARs).</p><p><strong>Material and methods: </strong>Computed tomography (CT) images, including high-risk clinical target volume (HR-CTV) and OARs structures, were analyzed from 46 treatment plans involving 32 patients undergoing intracavitary brachytherapy with tandem-ovoid applicator, using either traditional fixation (TRD) alone or in combination with patient transfer system (TRD + TS). Applicator displacement was assessed by measuring the distance between applicator base in two sets of CT images: one acquired during treatment planning (pre-plan), and second at dose delivery (pre-load). Dosimetric impact was evaluated for each simulated applicator shift.</p><p><strong>Results: </strong>The use of TRD + TS resulted in reduced applicator displacement compared with TRD alone. The mean magnitude of displacement decreased from 2.94 mm to 1.43 mm laterally, from 3.17 mm to 1.83 mm in the anterior-posterior direction, and from 3.45 mm to 2.00 mm longitudinally. Regarding dose variations to D_2cc for the bladder, rectum, sigmoid, and bowel, the average dose increases were 0.54%, 8.39%, 3.78%, and 0.58% for TRD, and 3.19%, 1.66%, 2.83%, and 1.19% for TRD + TS, respectively. No statistically significant difference was observed in either applicator displacement or radiation dose to OAR between the two systems.</p><p><strong>Conclusions: </strong>The combination of traditional fixation and patient transfer system have the potential to reduce applicator displacement, thereby enhancing treatment accuracy. However, in this study, no statistically significant difference was observed when compared with our traditional fixation method.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 3","pages":"183-190"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-surgical brachytherapy in the treatment of keloids: A single-center study.","authors":"Irene Gonzalez-Alaña, Patricia Martin-Playa, Leire Aparicio-Elizalde, Unay Yilmaz-Bescos, Francisco Casquero-Ocio, Itziar Valverde-Pascual, Silvia Perez-Fernandez, Jaime Carames-Estefania, Iñigo San Miguel-Arregui","doi":"10.5114/jcb.2025.151825","DOIUrl":"10.5114/jcb.2025.151825","url":null,"abstract":"<p><strong>Purpose: </strong>A keloid is a benign fibro-dermal tumor that produces an excess deposit of extra-cellular matrix. It usually occurs after a skin lesion, and it spreads beyond the wound. It is characterized by high recurrence rate after excision and lack of tendency of spontaneous involution. Multiple treatments have been described, with recurrence rates of up to 100%. One of the treatments considered most effective is combined therapy, i.e., surgery and subsequent radiotherapy using interstitial irradiation with iridium-192 (brachytherapy), with a clear reduction in recurrence rate.</p><p><strong>Material and methods: </strong>In our center, the technique was introduced in 2012, and the current retrospective observational study was conducted among 27 patients treated till December 2020.</p><p><strong>Results: </strong>The recurrence rate in the study was 25%, of which 83% recurred partially.</p><p><strong>Conclusions: </strong>The most frequent complications observed were dehiscence and infection of the surgical wound, therefore this therapeutic approach can be considered both safe and effective.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 3","pages":"153-159"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative cost-benefit analysis of electronic brachytherapy vs. high-dose-rate iridium-192 for exclusive vaginal cuff treatment in post-operative endometrial cancer.","authors":"Sergio Lozares-Cordero, Víctor González-Pérez, Marta Sánchez-Casi, Tomás González-González, Paula Castillo Peña, Mireia Pallarés-Ripollés, Antonio Herreros-Martínez, Santiago Pellejero-Pellejero","doi":"10.5114/jcb.2025.152539","DOIUrl":"10.5114/jcb.2025.152539","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the economic and dosimetric aspects of electronic brachytherapy (eBT) and high-dose-rate (HDR) iridium-192 (¹⁹²Ir) brachytherapy for exclusive vaginal cuff treatment in post-operative endometrial cancer patients.</p><p><strong>Material and methods: </strong>This retrospective observational study was conducted among 115 patients treated with eBT and 70 patients treated with HDR ¹⁹²Ir between 2019 and 2023 at two institutions. All patients underwent 3 fractions of 7 Gy prescribed to a uniform target volume. Dosimetric parameters, including D₉₀, V₁₅₀, and V₂₀₀ for high-risk clinical target volume (HR-CTV) as well as D_2cc, D_1cc, and D_0.1cc for organs at risk (OARs), such as bladder, rectum, and sigmoid colon, were compared. Economic analysis focused solely on cost differences related to source replacement and maintenance, as all other procedural factors (i.e., personnel, clinical workflow, and logistics) were identical for both modalities. The cost of bunker was not considered in the analysis.</p><p><strong>Results: </strong>Dosimetric analysis revealed comparable target volume coverage between eBT and HDR ¹⁹²Ir. The economic evaluation was focused on cost differences and their relative contributions. The relative average cost per patient under these assumptions was 18.4% lower for eBT (€273.9) than for HDR ¹⁹²Ir, based on Spanish pricing, largely due to differences in source-related expenditures.</p><p><strong>Conclusions: </strong>While ¹⁹²Ir HDR remains the standard in brachytherapy due to its versatility, eBT presents a cost-benefit alternative for exclusive vaginal cuff treatments, particularly in settings where infrastructure limitations restrict isotope-based brachytherapy. These findings support the complementary role of eBT in clinical practice, optimizing resource allocation without compromising dosimetric quality.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 3","pages":"160-167"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Near-fatal saddle pulmonary embolism following chemoradiotherapy and brachytherapy for locally advanced cervical cancer: A case series.","authors":"Lisa Leijtens, Jurgen Piek, Marlijn Kamps, Ada Oele-Egelmeer, Alette Daniëls-Gooszen, Ruud Bekkers, Jeltsje Cnossen","doi":"10.5114/jcb.2025.152543","DOIUrl":"10.5114/jcb.2025.152543","url":null,"abstract":"<p><strong>Purpose: </strong>Women with locally advanced cervical cancer treated with chemoradiotherapy followed by brachytherapy are at increased risk of venous thromboembolic events.</p><p><strong>Case presentation: </strong>This case series reported three women, who experienced near-fatal saddle pulmonary embolisms shortly after undergoing high-dose-rate brachytherapy for locally advanced cervical cancer. In one patient, pulmonary saddle embolism led to hypovolemic shock due to intra-abdominal hemorrhage post-resuscitation, necessitating emergency decompressive laparotomy. Another case was complicated by neurological symptoms consistent with a stuttering stroke, following mechanical pulmonary thrombectomy.</p><p><strong>Conclusions: </strong>Pulmonary embolism represents a severe complication of chemoradiotherapy and brachytherapy. Given the high morbidity and mortality rates associated with this condition, routine thromboprophylaxis may be warranted.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 3","pages":"197-201"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orchiepididymitis as a rare complication of TURP performed four weeks after high-dose-rate brachytherapy for prostate cancer.","authors":"Justyna Rembak-Szynkiewicz, Patrycja Mazgaj, Tomasz Szopin'ski, Arkadiusz Badzin'ski, Anna Hebda, Piotr Wojcieszek","doi":"10.5114/jcb.2025.152544","DOIUrl":"10.5114/jcb.2025.152544","url":null,"abstract":"<p><p>The aim of this paper was to present a rare complication of orchiepididymitis in a patient treated with brachytherapy (BT) for prostate cancer, who underwent trans-ureteral resection of the prostate (TURP) four weeks after BT. A 73-year-old patient with prostate cancer (intermediate-risk group) was eligible for high-dose-rate (HDR) BT combined with androgen deprivation therapy (ADT) for 6 months (leuprorelin). Due to increased symptoms, such as urinary retention after BT, the patient required catheterization. Additionally, bacterial inflammation in the lower urinary tract and prostate was present. Due to prolonged micturition disorders, TURP was performed, leading to chronic orchiepididymitis four months after completion of BT and three months after catheter removal following TURP. Due to long-term inflammation, which was resistant to treatment, the left testicle with left epididymis was removed. Unfortunately, inflammatory symptoms occurred post-operatively in the bed and the left groin. Since these symptoms of varying severity continued, anti-inflammatory drugs and analgesics were introduced. TURP performed too quickly after HDR-BT might cause severe complications. Extreme caution regarding TURP should be exercised in patients undergoing BT. Conservative and pharmacological treatment must be introduced in the occurrence of urinary disorders after BT, and any intervention (TURP) should be performed at least 3-6 months after BT. This is especially crucial because of the development of radiation effect over time.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 3","pages":"202-212"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Up to ten years of visual acuity outcomes in fellow eyes post-uveal melanoma treatment with iodine-125 radiotherapy, transpupillary thermotherapy, and proton beam therapy.","authors":"Amy Jasani, Logan Norris, Gerald McGwin, John O Mason","doi":"10.5114/jcb.2025.152469","DOIUrl":"10.5114/jcb.2025.152469","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess long-term visual acuity outcomes and multiple secondary factors in fellow eyes of uveal melanoma patients treated with either iodine-125 (¹²⁵I) plaque radiotherapy (PRT), transpupillary thermotherapy (TTT), or proton beam therapy (PBT).</p><p><strong>Material and methods: </strong>A retrospective chart review of 213 patients treated from 2000 to 2022 was performed, with baseline and post-treatment visual acuity data collected at follow-up time points up to 10 years, when available. Paired <i>t</i>-tests compared changes in visual acuity (VA) and intraocular pressure (IOP) over time for affected and fellow eyes. Spearman's rho test assessed correlations between melanoma thickness and VA over time, and repeated measures ANOVA determined interactions between time and comorbidities in VA.</p><p><strong>Results: </strong>Fellow eyes VA showed no significant change up to a decade post-treatment regardless of treatment modality, except for a likely false positive improvement at 2 years post-PRT. In contrast, affected eyes had significant VA decline post-PRT and PBT, while TTT used in affected eyes demonstrated no significant change. IOP did not show any significant changes in fellow eyes. Tumor thickness and the presence of diabetes, hypertension, or coronary artery disease, did not correlate with fellow eye VA outcomes.</p><p><strong>Conclusions: </strong>This study suggests that following uveal melanoma treatment with either ¹²⁵I PRT, TTT, or PBT, fellow eyes remain stable regarding VA and other outcomes up to 10 years. This provides important information for treatment choice in patients with ocular melanoma, especially as VA can decline in affected eye post-treatment, leading to reliance on contralateral eye.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 3","pages":"168-173"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brachytherapy for eyelid cancers: Re-defining outcomes and esthetics in rare histologies.","authors":"Sarbani Ghosh Laskar, Anuj Kumar, Prashasti Sharma, Ashwini Budrukkar, Monali Swain, Shwetabh Sinha, Samarpita Mohanty, Muhammed Anaz, Shrikant Kale","doi":"10.5114/jcb.2025.152540","DOIUrl":"10.5114/jcb.2025.152540","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate local control, cosmetic outcomes, toxicities, and survival outcomes of interstitial high-dose-rate (HDR) brachytherapy treatment in non-basal cell carcinoma malignancies of the eyelid.</p><p><strong>Material and methods: </strong>This retrospective study analyzed patients with histopathologically confirmed eyelid malignancies treated with adjuvant HDR interstitial brachytherapy (¹⁹²Ir) between August 2007 and August 2024. Outcomes assessed included loco-regional control (LRC), disease-free survival (DFS), overall survival (OS), and toxicities graded by the Radiation Therapy Oncology Group (RTOG). Kaplan-Meier analysis estimated survival rates, while cosmetic outcomes were evaluated using cosmetic assessment of intraocular brachytherapy (CAIB) scale.</p><p><strong>Results: </strong>Eighteen patients with sebaceous (72.2%) and squamous (22.2%) histologies received 21-49 Gy in 7-14 frac-tions (3-3.5 Gy/fraction). With a median follow-up of 21.93 (IQR, 10.6-152.83) months, no loco-regional recurrences were observed among 13 patients with documented follow-up (LRC, 100%). Two patients died (one from systemic progression without local failure and the other from COVID-19), and three were lost to follow-up. The 5-year OS and DFS rates were 83.3%. Cosmetic outcomes were rated excellent in 55.55% and very good in 44.44% of patients. No grade 3 and above acute toxicities occurred, and eyelid/eye function was preserved in 88.88% (16/18), ensuring organ preservation without late toxicity.</p><p><strong>Conclusions: </strong>Adjuvant HDR brachytherapy is a safe and effective treatment for eyelid malignancies, achieving excellent local control, superior cosmetic outcomes, and acceptable toxicity. This modality optimizes tumor control, while preserving function and esthetics in this anatomically sensitive region.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 3","pages":"174-182"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The irreplaceable art of brachytherapy: A technical note on interstitial high-dose-rate interventional radiotherapy (brachytherapy) in eyelid tumors.","authors":"Tanvir Pasha, Nikhila Radhakrishna, Sushma Poojar, Rashmi Shivananjappa, Bharathi Krishnamoorthy, Naveen Thimmaiah","doi":"10.5114/jcb.2025.152542","DOIUrl":"10.5114/jcb.2025.152542","url":null,"abstract":"<p><strong>Purpose: </strong>Eyelid tumors are uncommon malignancies, where 75% of cases are cutaneous basal cell carcinoma (BCC), and sebaceous cell carcinoma, squamous, adenocarcinoma from meibomian glands are diagnosed in 25%. Post-excision adjuvant radiotherapy (ART) is indicated in high-grade tumors with positive margins and lymphovascular space or perineural invasion. The ideal technique for delivering ART for eyelid tumors is interstitial brachytherapy (ISBT). However, its use is limited by steep learning curve. Here, we described the stepwise procedure of ISBT performed in eyelid tumors with reported outcomes.</p><p><strong>Material and methods: </strong>Four patients with sebaceous carcinoma of the upper eyelid underwent ART, and 2 of the 4 patients had positive margins. Tumor bed was delineated with a 0.5-1 cm margin circumferentially. Under short general anesthesia, 2-3 hollow ISBT needles were inserted in a single-plane into tumor bed, 1 cm apart. Tarsal margin was avoided by > 2 mm to prevent eyelid contractures. Needles were replaced with 6 Fr flexible nylon catheters and fixed with buttons, ensuring a 5 mm gap from the skin to allow post-procedural edema. 3.5 Gy in 12-14 fractions were planned to achieve EQD₂ dose of 60 Gy for R0 resection and 66 Gy for R1 resection, delivered twice a day with more than 6 hours interval. A wax-coated lead shield was placed to protect the cornea and lens using 0.4% paracaine eye drops. <i>In vivo</i> dosimetry was performed using metal-oxide-semiconductor field-effect transistor (MOSFET).</p><p><strong>Results: </strong>The mean clinical target volume (CTV) was 2.1 cc, the target D₉₀ was 3.37 Gy/fraction. The target V100% was 86.27%, V150% was 31%, and V200% was 11.33%. The lens D_max (TPS) was 1.28 Gy/fraction, while the mean dose recorded by MOSFET was 0.7 Gy/fraction. No conjunctival acute toxicities were observed. Grade 1 skin reaction (hyperpigmentation) was noted, with no local recurrences at 1 year median follow-up.</p><p><strong>Conclusions: </strong>ART delivered by ISBT in eyelid tumors is a simple and efficient brachytherapy procedure, providing excellent cosmesis and local control.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 3","pages":"191-196"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality control strategies for head and neck brachytherapy (interventional radiotherapy).","authors":"Bruno Fionda, Elisa Placidi, Enrico Rosa, Valentina Lancellotta, Maria Vaccaro, Patrizia Cornacchione, Martina De Angeli, Sara Scalise, Gabriele Ciasca, Francesco Pastore, Víctor González-Pérez, Francesco Miccichè, Mariangela Massaccesi, Maria Antonietta Gambacorta, Jacopo Galli, Francesco Bussu, Marco De Spirito, Luca Tagliaferri","doi":"10.5114/jcb.2025.150065","DOIUrl":"10.5114/jcb.2025.150065","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate quality control (QC) strategies to enhance treatment delivery in interventional radiotherapy (IRT) for head and neck (H&N) cancers, focusing on ensuring the accuracy of therapy while addressing specific challenges, such as catheter displacement and tube misconnection.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted among 30 patients treated with IRT for nasal vestibule or eyelid cancers at our institutional center from January 2022 to December 2023. All treatments involved 14 fractions over nine days. QC measures were implemented to monitor catheter placement and prevent misconnection, with daily visual checks and mid-course CT evaluations. Distance measurements between catheter markers were compared across scans, and variations exceeding 2 mm prompted re-planning. Statistical analyses included one-way <i>t</i> tests to assess marker displacement significance.</p><p><strong>Results: </strong>A total of 420 fractions were delivered, and 360 marker distance measurements were analyzed. No significant differences were observed between initial and mid-course CT scans (mean distances, 35.2 ±10.5 mm and 35.9 ±10.5 mm, respectively). However, in 16.6% of cases, re-planning was required due to catheter displacement or marker variation exceeding 2 mm. Notably, patients with nasal vestibule cancers demonstrated higher number of catheters and increased risk of displacement. Dosimetric evaluation confirmed significant dose distribution changes in a sub-set of cases, highlighting the clinical importance of QC.</p><p><strong>Conclusions: </strong>Quality control strategies are essential to ensure precise treatment delivery in H&N IRT, especially in complex anatomical sites and risk of catheter displacement. Implementation of systematic checks and re-planning criteria enhances patient safety and treatment efficacy. Further research is warranted to refine QC measures and evaluate their impact on clinical outcomes.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 2","pages":"127-132"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of risk factors for difficult-to-control pain (VAS score > 3) at two months after late-stage non-small cell lung cancer treatment with iodine-125 radioactive particle implantation combined with chemotherapy.","authors":"Tingting Ding, Jinjin Liu, Wenwen Zhang, Guoxu Zhang","doi":"10.5114/jcb.2025.151520","DOIUrl":"10.5114/jcb.2025.151520","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore the risk factors associated with difficult-to-control pain (visual analog scale [VAS] score > 3) experienced by patients with advanced non-small cell lung cancer (NSCLC) assessed at two months after receiving iodine-125 (¹²⁵I) radioactive seed implantation combined with chemotherapy, in order to improve pain management and enhance patient quality of life.</p><p><strong>Material and methods: </strong>A total of 87 patients diagnosed with advanced NSCLC were included in the study, all of whom underwent treatment using ¹²⁵I radioactive seed radiotherapy and chemotherapy. Through univariate and multivariate analyses, the risk factors affecting pain control at two months post-treatment were identified. Predictive and survival analyses were done using ROC curves and Kaplan-Meier survival curves.</p><p><strong>Results: </strong>The results indicated that minimal pleural distance, smoking history, and pleural effusion were independent risk factors influencing the control of pain shown in VAS scores. Moreover, a non-linear relationship between minimal pleural distance and difficulty of pain control was observed, indicating that the risk of uncontrolled pain decreases when the minimal pleural distance reaches ≥ 10.84 millimeters. ROC curve analysis demonstrated that the predictive capability of minimal pleural distance was the highest.</p><p><strong>Conclusions: </strong>Minimal pleural distance, smoking history, and pleural effusion are significant factors in predicting the difficulty of pain control in patients with advanced NSCLC receiving ¹²⁵I radioactive seed implantation combined with chemotherapy at two months post-treatment. Patients with a minimal pleural distance of less than 10.84 millimeters are more likely to experience uncontrolled pain after treatment. Therefore, developing predictive models may assist clinicians in more accurately evaluating treatment efficacy and patients' pain management needs.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"17 2","pages":"115-126"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}