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Gemcitabine + iodine-125 brachytherapy is a combination treatment regimen investigated by Huazhong University of Science and Technology for the management of unresectable locally advanced pancreatic cancer. Gemcitabine is a pyrimidine nucleoside analog that functions as an antimetabolite; it is phosphorylated intracellularly into active metabolites that inhibit ribonucleotide reductase and compete with deoxycytidine triphosphate for incorporation into DNA, leading to chain termination and apoptosis. Beyond its cytotoxic effects, gemcitabine is a potent radiosensitizer, enhancing the efficacy of concurrent radiation therapy. Iodine-125 (125I) brachytherapy involves the interstitial implantation of radioactive seeds directly into the tumor, providing continuous, low-dose-rate gamma radiation that induces localized DNA damage and cell death. This combination approach aims to improve local tumor control and survival outcomes by leveraging the synergistic interaction between systemic chemotherapy and localized internal radiation.
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