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Bone pain from spinal metastases: Iodine-125 brachytherapy
  1. Hongxue Shao,
  2. Lei Teng,
  3. Junzhu Dai,
  4. Wenhui Zhang,
  5. Shiyan Lin,
  6. Liuyuan Zhao and
  7. Huichao Zou
  1. Pain Medicine, Harbin Medical University Cancer Hospital, Harbin, China
  1. Correspondence to Dr Huichao Zou, Dept. Pain Medicine, Harbin Medical University Cancer Hospital, 150081, Harbin, Heilongjiang, China; zouhuichao{at}


Objectives This study evaluated the analgesic efficacy and safety of CT-guided iodine-125 (125I) brachytherapy in patients with spinal metastasis-induced pain who were not suitable to receive radiotherapy.

Methods A cohort of 68 patients with spinal metastasis induced pain not fully relieved by opioids and did not receive external beam radiation therapy due to poor general status were enrolled and underwent CT-guided 125I brachytherapy for analgesic treatment.

Results Patients were followed for 8 weeks after brachytherapy. Mean Numerical Rating Scale score before brachytherapy was 7.3±1.3 and decreased to 3.3±0.9, 2.6±0.8, 2.7±0.8, 2.9±0.9 and 3.3±1.1 at weeks 1, 2, 4, 6 and 8, respectively, after brachytherapy. Daily dose of morphine equivalent was 105.1±28.0 mg before brachytherapy and decreased to 45.3±13.7, 39.9±14.2, 40.4±14.9, 48.5±18.0 and 62.4±17.5 mg at weeks 1, 2, 4, 6 and 8, respectively, after brachytherapy. Patients had fewer daily episodes of breakthrough pain after brachytherapy (p<0.001). Patients had improvement in pain-related functional interference and in hospital anxiety and depression score after brachytherapy.

Conclusions CT-guided 125I brachytherapy is an effective and safe intervention for patients with spinal metastasis-induced pain who are not able to receive radiation therapy.

  • pain
  • terminal care
  • quality of life

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  • Contributors HS: conceived the original idea. LT and JD: data collection. WZ, SL and LZ: statistical analysis. HZ: study design and responsible for the overall content of the article.

  • Funding This work was sponsored by research funding from the Health Commission of Heilongjiang Province (204-058).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.