Efficacy and prognostic factors analysis of CT-guided 125I seeds implantation for primary hepatocellular carcinoma
10.3760/cma.j.cn321828-20210421-00133
- VernacularTitle:CT引导下 125I粒子植入治疗原发性肝癌疗效及预后影响因素分析
- Author:
Qianqian YUAN
1
;
Miaomiao HU
;
Yanli MA
;
Yuqing SONG
;
Chuang HE
;
Xuequan HUANG
;
Chongshuang YANG
;
He ZHU
;
Zhe WANG
;
Kaixian ZHANG
;
Junjie WANG
;
Jiuyan ZHANG
;
Bin LIU
Author Information
1. 滕州市中心人民医院肿瘤科，滕州 277500
- Keywords:
Liver neoplasms;
Brachytherapy;
Iodine radioisotopes;
Tomography, X-ray computed;
Prognosis
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2022;42(11):666-671
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and prognostic factors of 125I seeds implantation for primary hepatocellular carcinoma. Methods:From December 2011 to January 2021, 102 primary hepatocellular carcinoma patients (86 males, 16 females; median age 61 years) who underwent 125I seeds implantation from 5 hospitals in China were enrolled in this retrospective study. Local progression-free survival (LPFS), overall survival (OS) and the prognostic factors were analyzed. Kaplan-Meier method was used to draw the distribution curve of survival time, and LPFS rate and OS rate were calculated. Log-rank test and Cox regression were used to analyze the influencing factors of survival. Results:The median follow-up time was 38 months until April 2021. The local control rate was 96.1%(98/102). The 1-, 3- and 5-year LPFS rate were 61.3%, 25.5% and 12.7%, and the 1-, 3- and 5-year OS rate were 73.9%, 39.1% and 22.6%, respectively. There were 75 patients with progressive disease, including 42 patients with intrahepatic recurrence and metastasis after seed implantation, and 55 patients died. Multivariate analyses showed that short-term efficacy complete response (CR) (hazard ratio ( HR)=0.34, 95% CI: 0.20-0.58) was protective factor related to LPFS; short-term efficacy CR ( HR=0.25, 95% CI: 0.13-0.47) was the protective factors related to OS; Barcelona clinic liver cancer (BCLC) C stage ( HR=2.33, 95% CI: 1.27-4.27), intrahepatic progression and extrahepatic metastasis ( HR=3.18, 95% CI: 1.28-7.86; HR=3.23, 95% CI: 1.27-8.21) were independent risk factors related to OS. No sever adverse effects were observed. Conclusions:125I seeds implantation is safe and effective for the treatment of primary hepatocellular carcinoma. BCLC stage, short-term efficacy and post-implantation progression are independent factors related to survival time.
