OBJECTIVETo evaluate the clinical value of iodine[131I] metuximab infusion combined with transcatheter arterial chemoembolization (TACE) for treating cases of post-intervention relapse of mid or advanced stage hepatocellular carcinoma (HCC).

METHODSSixty patients who were diagnosed between March 2009 and June 2010 with relapse of mid or advanced stage HCC following previous intervention with various standard clinical methods were recruited for study. The patients were randomly and equally divided into a control treatment group (CG; receiving TACE therapy alone) and an experimental treatment group (TG; receiving TACE combined with iodine [131I] metuximab injection). For all patients, licartin was first perfused into the tumor feeding artery and then the TACE procedure was performed 20 min later. Liver function markers and routine blood parameters, including alpha-fetoprotein (AFP) and clotting time, were examined at one week and one month after the treatment. Enhanced computed tomography or magnetic resonance imaging of the liver was performed at one month after treatment and thereafter on a bi-monthly follow-up schedule. The World Health Organization's tumor evaluation standard was used to assess the therapeutic effects in each group. Results of laboratory tests (pre- and post-treatment), reported complications, and side-effects were evaluated for their contributions to time of tumor progression (TTP) and survival time.

RESULTSPatients in the TG and CG groups had similar blood cell counts at pre-operative and 1-week postoperative time points. The TG group showed a significantly reduced level of AFP following treatment, but it was not significantly different from the level in the CG group. The TG group did however show significantly different levels of liver functional parameters (all P less than 0.05) and significantly higher TTP (4.84+/-4.11 vs. CG: 2.54+/-2.08 months; t = -2.13, P less than 0.05) and average survival time (7.05 vs. 5.15 months; x2 = 4.24, P = 0.039). The rates of partial response (PR), slight remission (MR), unchanged status (SD) and progressive disease (PD) were 16.7%, 37.5%, 25.0% and 20.8% in the TG group, and 8.7%, 17.4%, 21.7% and 52.2% in the CG group. The therapeutic effect rate (CR + PR + MR) and reaction rate (CR + PR + MR + SD) was significantly different between the two groups (P = 0.048). No serious adverse effects were reported.

CONCLUSIONTACE combined with iodine [131I] metuximab injection is a safe and effective procedure for prolonging the survival and TTP of patients with HCC relapse following prior therapeutic intervention.