Surgical bypass and permanent iodine-125 seed implantation vs. surgical bypass for the treatment of pancreatic head cancer.

The present study aimed to investigate the efficacy and safety of Iodine-125 (I-125) seed implantation in the treatment of locally advanced unresectable pancreatic head cancer. A prospective nonrandomized study was performed using data collected from patients between January 2009 and December 2012. A total of 34 patients underwent surgical bypass and permanent I-125 seed implantation (group A), and 32 patients underwent biliary and gastric bypass (group B). The preoperative variables, operative data, postoperative complications and follow-up information were examined. No significant differences were identified in clinical characteristics, mortality, morbidity and length of hospital stay between the two groups. Tumor responses were significantly different between between patients in group A and B (partial response, 56 vs. 0%, P < 0.001; progression, 24 vs. 84%, P=0.013). The time until disease progression was significantly longer in group A compared to group B (8 +/- 1 vs. 5 +/- 2 months; P < 0.001). The median survival time was significantly longer in group A compared to group B (11 vs. 7 months; P < 0.001). The quality of life was improved significantly in group A compared to group B. In the first month following surgery, pain scores were improved (24 +/- 10 vs. 54 +/- 19; P < 0.001). Following repeated measure analysis, pain scores were significantly lower in group A compared to group B (P < 0.05) at 9 months following surgery. The results of the present study suggest that I-125 seed implantation is feasible, safe and effective for the treatment of unresectable pancreatic head cancer.