Chongqing- The Nuclear Medicine Department at the Southwest Hospital of Army Medical University (AMU) used iodine-125 particles permanent implantation to conduct brachytherapy for the communicating adenoid cystic carcinoma (ACC) first time in the world.

The treatment team combined the physical properties of iodine-125 particles with minimally invasive surgery to treat the tumor in parts, avoiding the huge trauma caused by surgery.

A picture of the Southwest Hospital of Army Medical University in Chongqing. (Photo/ the Southwest Hospital of Army Medical University)

What is ACC?

ACC is a rare form of adenocarcinoma, a type of cancer that begins in epithelial tissues. It most commonly arises in the head and neck's major and minor salivary glands. It can also occur in the breast, uterus, or other locations in the body.

The majority of people who develop the disease are between the ages of 40 and 60.

Problem-solving of communicating tumors

Among them, Ms. Liu, 74 years old, was diagnosed with ACC of her right nasal cavity. The tumor gradually increased in size in two years and finally formed into a giant ACC of the right nasal cavity-anterior cranial fossa, measuring approximately 9.7 × 6 cm.

At that time, Liu was suffering from cranial and right eye distention, blurred vision, significant nasal obstruction, and difficulty walking and was confined to a wheelchair.

"Her tumors penetrate the basicranial structure, which means that these tumors are intracranial and extracranial," said Professor Huang at the Nuclear Medicine Department of the Southwest Hospital of AMU. "We called them communicating tumors."

Professor Huang said that the surgical resection of such tumors is difficult, and the adjacent tissues and nerves have a high risk of functional damage.

However, if not actively treated, the condition will be further aggravated. The treatment scheme was finally determined as the iodine-125 particles implantation brachytherapy.

"Iodine-125 particles implantation is a radiation therapy assisted by interventional technology," said Professor Huang. "The radiation dose can reach the level of the radical dose, and only one operation is needed."

Professor Huang said that it has little damage to adjacent tissues, nerves, and brain functions. The patient has good tolerance and high acceptance because it is a minimally invasive operation.

During the operation, Professor Huang established a puncture channel with an electric drill, inserted a particle-carrying needle, and delivered iodine-125 particles according to the planned distance.

Postoperative re-examination showed that CT particles were evenly distributed in the lesions. The operation was very successful without complications.

Surgery scene. (Photo/ Southwest Hospital of Army Medical University)

Liu returned to the hospital for a check after two months, and the expected effect of the operation was achieved. The long-term effect will be further followed up.

According to Professor Huang, this serves as the world's first case of using iodine-125 particles permanent implantation to conduct brachytherapy for the communicating adenoid cystic carcinoma, after reviewing the relevant literature at home and abroad.

(Shi Jiaqi, as an intern, also contributed to this report.)