Iodine-125 Seed Implantation Therapy for Locally Advanced Pancreatic Cancer

Inclusion Criteria:

• Age: 18-80 years

• Cytologically or histologically confirmed pancreatic adenocarcinoma

• Inoperable locally advanced pancreatic cancer based on American Joint Committee onCancer (AJCC) staging system (8th ed) (without distant metastasis)

• Single tumor size≤ 6 cm

• Karnofsky performance score （KPS）≥60

• Estimated survival ≥3 months

• Without other several comorbidity

• Participants must have adequate organ function:

• WBC≥3×109/L; HGB≥90g/dL; PLT≥50×109/L

• Aspartate Transaminase (AST)/alanine aminotransferase ( ALT) ≤3 × institutionalupper limit of normal

• Albumin≥3g/dL

• Total bilirubin ≤3mg/dL

• PT≤3 × institutional upper limit of normal or INR≤2.3

• Creatinine ≤1.5 × institutional upper limit of normal

• Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

• Patients with other malignant tumors

• History of other anti-cancer therapy, including surgery,radiation, ablation and so on

• Pregnant or lactating women

• Patients with Immunodeficiency disease

• Several heart disease, for example: New York Heart Association (NYHA) class III/IVcongestive heart failure，active coronary heart disease and severe arrhythmia

• Uncontrolled hypertension

• Ongoing or active infection (＞grade 2 based on National Cancer Institute-CommonTerminology Criteria for Adverse Events (NCI-CTCAE) 4.0 edition)

• Active tuberculosis

• Chronic renal insufficiency

• Other organ failure

• History of organ transplantation

• History of severe mental illness