Therapeutic effect of transcatheter arterial chemoembolization combined with iodine-125 seed strand implantation for treating hepatocellular carcinoma with portal vein tumor thrombus
10.3760/cma.j.issn.1007-8118.2019.12.002
- VernacularTitle: 门静脉125I粒子条联合肝动脉化疗栓塞治疗原发性肝癌合并门静脉癌栓的疗效
- Author:
Liang YANG
1
;
Yuming GU
;
Hao XU
;
Xun WANG
;
Jiao LU
;
Ang LIU
Author Information
1. Department of Interventional Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221006, China
- Publication Type:Journal Article
- Keywords:
Carcinoma, hepatocellular;
Portal vein tumor thrombus;
Transcatheter arterial chemoembolization;
Iodine radioisotopes
- From:
Chinese Journal of Hepatobiliary Surgery
2019;25(12):885-889
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the efficacy of combined transcatheter arterial chemoembolization (TACE) with iodine-125 seed implantation in treating hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).
Methods:From January 2015 to January 2019, eighty patients with HCC and PVTT who were treated at Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. A total of 71 patients were male and 9 were female, aged (53.1±9.9) years. The patients included 48 patients (group A) who were treated with TACE alone and 32 patients (group B) with TACE combined with iodine-125 seed implantation. The survival time and disease control rate (DCR) of the intrahepatic lesions and PVTT in the two groups were compared.
Results:There were 32 patients who were successfully implanted with portal vein iodine-125 seed and stents. The DCR of PVTT in group B was significantly better than in group A (90.6% vs. 81.3%, P<0.05). The DCR of the intrahepatic lesions in the two groups was 77.1% (group A) and 90.6% (group B). There was no significant difference between the two groups (P>0.05). The survival times of group A and group B were (8.0±0.6) and (16.0±2.1) months, respectively. The median survival times were (7.6±1.0) and (14.8±1.5) months respectively. Group B had significantly better survival time than Group A, (both P<0.05). Univariate and multivariate analysis showed that tumor size was an independent risk factor of prognosis (Regression coefficient: 0.960, HR: 0.383, 95% CI: 0.158-0.926, P<0.05). 125I treatment was a protective factor of prognosis (Regression coefficient: -1.525, HR: 0.218, 95% CI: 0.100-0.473, P<0.05).
Conclusion:For patients with HCC and PVTT, compared with TACE alone, TACE combined with iodine-125 seed implantation could safely and effectively control portal vein tumor thrombus, and prolonged patient survival.
