125Iodine seed implantation and gamma knife for the treatment of portal vein tumor thrombosis in hepatocellular carcinoma：comparison of therapeutic efficacy
10.3969/j.issn.1008-794X.2014.08.012
- VernacularTitle:125I粒子植入与伽玛刀治疗门脉癌栓的疗效对比
- Author:
Haiwei LI
;
Jing LIU
;
Sen LI
- Publication Type:Journal Article
- Keywords:
primary hepatocellular carcinoma;
portal vein tumor thrombosis;
125Iodine seed implantation
- From:
Journal of Interventional Radiology
2014;(8):702-705
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the therapeutic efficacy of 125Iodine seed implantation and gamma knife in treating portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC), and to discuss their clinical applications. Methods Between January 2009 and May 2013, a total of 60 HCC patients associated with PVTT were encountered at authors’ hospital. The patients were divided into gamma knife group (n=30) and 125Iodine seed group (n = 30). Gamma knife treatment was carried out for the patients of gamma knife group. A total of 3 - 10 target points were designed. Single dose of 3 - 6 Gy per fraction was used and 2 - 5 times radiotherapy every week were conducted. The total treatment dose was 30 - 50 Gy. In designing the therapeutic scheme, 50%-70%of iso-dose curve contained PTV. 125Iodine seed implantation was performed for the patients of 125Iodine seed group. After the treatment, the change of PVTT size was assessed. The clinical efficacy was evaluated. Results Three months after the treatment, in gamma knife group complete remission (CR) was seen in 0 patient (0%), partial remission (PR) in 8 patient (26.6%), stable disease (SD) in 17 patients (56.7%) and progressive disease (PD) in 5 patients (16.7%). In 125Iodine seed group, CR was obtained in 3 patients (10.0%), PR in 19 patients (63.4%), SD in 7 patients (23.3%) and PD in one patient (3.3%). Statistically significant differences in responding the therapy existed between the two groups (P < 0.05), although no significant difference in the improvement of ascites and hepatic function existed between the two groups (P<0.05). Conclusion For the treatment of portal vein tumor thrombosis of hepatocellular carcinoma, the short-term efficacy of 125Iodine seed implantation is much better than that of gamma knife, although its long-term effect needs to be further studied.
