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Li L, Liu S, Wang Q, Wang Y, Yu G. Hepatic artery infusion chemotherapy with systemic capecitabine and camrelizumab for treating unresectable hilar cholangiocarcinoma: An initial investigation of efficacy and safety. J Cancer Res Ther 2024; 20:578-583. [PMID: 38687927 DOI: 10.4103/jcrt.jcrt_1549_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 02/02/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE This study aimed to evaluate the efficacy and safety of sequential treatment of continuous transcatheter hepatic artery infusion chemotherapy (HAIC) with systemic capecitabine monotherapy and camrelizumab for treating unresectable hilar cholangiocarcinoma (HCCA). METHODS This study retrospectively analyzed patients with unresectable HCCA admitted to Linyi Cancer Hospital in Shandong Province from October 2019 to December 2021. All enrolled patients were treated with HAIC (mFOLFOX7) + camrelizumab for 2-6 cycles and administered systemic therapy with capecitabine and camrelizumab. The objective response rate (ORR), disease control rate (DCR), and adverse reactions of patients were assessed. The Kaplan-Meier method was used to describe overall survival (OS), and univariate and multivariate Cox regression models were utilized to analyze the influencing factors of OS. RESULTS This study included 34 patients, ORR was 61.76% (21/34), and DCR was 97.06% (33/34) after two HAIC cycles. The median follow-up time was 17.5 months, with an average of 18.32 ± 8.06 months, and the median OS was 20.0 months. HAIC-related adverse reactions included mainly gastrointestinal symptoms and hematological toxicity caused by chemotherapy drugs, all of which were grades 1-2. Further, adverse events for camrelizumab treatment included fatigue, skin rash, and hypothyroidism, all of which were grade <3. Cox regression analysis revealed that the periductal infiltrating type of growth pattern indicated a worse OS, whereas more HAIC cycles (5 ~ 6) were a protective factor for OS. CONCLUSION HAIC sequentially combined with systemic capecitabine chemotherapy and a programmed death-1 inhibitor displayed favorable effects for unresectable HCCA, with controllable adverse reactions.
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Affiliation(s)
- Long Li
- Qingdao Medical College of Qingdao University, No. 1, Ningde Road, Qingdao 266073, Shandong Province, China
- Interventional Medicine Center, Linyi Cancer Hospital, Intersection of Zhicheng Road and Zhongsheng Street, Linyi 276034, Shandong Province, China
| | - Song Liu
- Interventional Medicine Center, Linyi Cancer Hospital, Intersection of Zhicheng Road and Zhongsheng Street, Linyi 276034, Shandong Province, China
- Graduate School of Dalian Medical University, No. 9 Western Section, Lvshun South Street, Lvshun District, Dalian, 116044, Liaoning Province, China
| | - Qingdong Wang
- Interventional Medicine Center, Linyi Cancer Hospital, Intersection of Zhicheng Road and Zhongsheng Street, Linyi 276034, Shandong Province, China
| | - Yanhua Wang
- Qingdao Medical College of Qingdao University, No. 1, Ningde Road, Qingdao 266073, Shandong Province, China
- Interventional Medicine Center, Affiliated Hospital of Qingdao University, No. 369, Shanghai Road, Pingdu City, Qingdao 266073, Shandong Province, China
| | - Guangji Yu
- Interventional Medicine Center, Linyi Cancer Hospital, Intersection of Zhicheng Road and Zhongsheng Street, Linyi 276034, Shandong Province, China
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Yu H, Wang X, Wang R, Peng G, Gong L. Perceptions of transitional care services among patients with percutaneous transhepatic biliary drainage and multicentre health professionals: A qualitative study. Health Expect 2024; 27:e13913. [PMID: 37986546 PMCID: PMC10726261 DOI: 10.1111/hex.13913] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Patients with percutaneous transhepatic biliary drainage (PTBD) need regular drainage tube care after discharge, and transitional care can help solve this problem. However, few studies have focused on the quality of transitional care, the perceptions of patients with drainage tubes after discharge and those of healthcare professionals. AIM This study is aimed at exploring the real experience and perceptions of transitional care services among healthcare professionals and PTBD patients who have been discharged with tubes and at providing references for future transitional care service development. DESIGN The study uses a qualitative descriptive design. The reporting method followed Consolidated Criteria for Reporting Qualitative Research guidelines. METHODS Semistructured interviews were conducted with PTBD patients who had been discharged with tubes and multicentre healthcare professionals using the purpose sampling method. The thematic analysis method was used for analysis. RESULTS Thirteen PTBD patients from one hospital and 12 healthcare professionals from three hospitals were interviewed. The analysis of the patient interview data revealed three themes, namely, recognition of the value of transitional care services, patients have some unmet needs and perception of transitional care service pathways. Six subthemes were also identified. The analysis of the interview data of healthcare professionals revealed two themes, namely, harvest and challenges in transitional care services work and expectations for future development of transitional care services. Four subthemes were also identified. CONCLUSIONS The transitional care of discharged patients with PTBD tubes deserves the attention of clinical workers, and a series of measures should be taken to improve transitional care services. PATIENT/PUBLIC CONTRIBUTION Patients were involved in the formulation of interview questions for this study, and during the interviews, patients presented their suggestions for transitional care services. Healthcare professionals participated in this study as interviewees, and no members of the public were involved in this study.
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Affiliation(s)
- Huan Yu
- Department of Hepatobiliary Surgerythe Second Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Xiaomei Wang
- Department of Hepatobiliary Surgerythe Second Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Rui Wang
- Department of Hepatobiliary Surgerythe Second Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Guoqing Peng
- Department of Hepatobiliary Surgerythe Second Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Liyun Gong
- Department of Hepatobiliary Surgerythe Second Affiliated Hospital of Chongqing Medical UniversityChongqingChina
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Chen Y, Zhang C, Luo T. Percutaneous transhepatic cholangial drainage/percutaneous transhepatic biliary stent implantation for treatment of extrahepatic cholangiocarcinoma with obstructive jaundice. Shijie Huaren Xiaohua Zazhi 2023; 31:165-171. [DOI: 10.11569/wcjd.v31.i5.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Extrahepatic cholangiocarcinoma is a malignant tumor originating from the extrahepatic bile duct including the hilar region to the lower bile duct of the common bile duct. With the development of interventional techniques and medical materials, percutaneous transhepatic cholangial drainage (PTCD) or percutaneous transhepatic biliary stent implantation (PTBS) has become the main treatment to relieve biliary obstruction. However, the occurrence of postoperative complications seriously affects the prognosis of patients, and the combination of biliary stenting with local treatment has been found to significantly prolong the time to biliary patency. This article reviews the progress of PTCD/PTBS in the treatment of extrahepatic cholangiocarcinoma with obstructive jaundice, evaluates its clinical efficacy, and points out the current problems and posible solutions to provide more reference for subsequent related studies.
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Affiliation(s)
- Yue Chen
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Chao Zhang
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Tao Luo
- Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Liu R, Li H, Qiu Y, Liu H, Cheng Z. Recent Advances in Hepatocellular Carcinoma Treatment with Radionuclides. Pharmaceuticals (Basel) 2022; 15:1339. [PMID: 36355512 PMCID: PMC9694760 DOI: 10.3390/ph15111339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 06/20/2024] Open
Abstract
As the third leading cause of cancer death worldwide, hepatocellular carcinoma (HCC) is characterized by late detection, difficult diagnosis and treatment, rapid progression, and poor prognosis. Current treatments for liver cancer include surgical resection, radiofrequency ablation, liver transplantation, chemotherapy, external radiation therapy, and internal radionuclide therapy. Radionuclide therapy is the use of high-energy radiation emitted by radionuclides to eradicate tumor cells, thus achieving the therapeutic effect. Recently, with the continuous development of biomedical technology, the application of radionuclides in treatment of HCC has progressed steadily. This review focuses on three types of radionuclide-based treatment regimens, including transarterial radioembolization (TARE), radioactive seed implantation, and radioimmunotherapy. Their research progress and clinical applications are summarized. The advantages, limitations, and clinical potential of radionuclide treatment of HCC are discussed.
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Affiliation(s)
- Ruiqi Liu
- Institute of Molecular Medicine, College of Life and Health Sciences, Northeastern University, Shenyang 110000, China
| | - Hong Li
- Institute of Molecular Medicine, College of Life and Health Sciences, Northeastern University, Shenyang 110000, China
| | - Yihua Qiu
- Institute of Molecular Medicine, College of Life and Health Sciences, Northeastern University, Shenyang 110000, China
| | - Hongguang Liu
- Institute of Molecular Medicine, College of Life and Health Sciences, Northeastern University, Shenyang 110000, China
| | - Zhen Cheng
- State Key Laboratory of Drug Research, Molecular Imaging Center, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
- Shandong Laboratory of Yantai Drug Discovery, Bohai Rim Advanced Research Institute for Drug Discovery, Yantai 264117, China
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Zhao G, Liu S, Liu Y, Li X, Yu G, Zhang Y, Bian J, Wu J, Zhou J, Gao F. CalliSpheres® microsphere transarterial chemoembolization combined with 125I brachytherapy for patients with non–small‐cell lung cancer liver metastases. Front Oncol 2022; 12:882061. [PMID: 36033546 PMCID: PMC9413194 DOI: 10.3389/fonc.2022.882061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/07/2022] [Indexed: 12/04/2022] Open
Abstract
Objective Poor prognosis and limited treatments of liver metastases from non–small‐cell lung cancer (NSCLC) after radical surgery are critical issues. The current study aimed to evaluate the efficacy and safety of CalliSpheres® microsphere transarterial chemoembolization (CSM-TACE) plus 125I brachytherapy in these patients. Methods A total of 23 patients with liver metastases from NSCLC after radical surgery were included. All patients received CSM-TACE 1–3 times, then 125I brachytherapy was carried out following the last CSM-TACE. Complete response (CR), objective response rate (ORR), disease control rate (DCR), survival, and adverse events were evaluated. Results CR, ORR and DCR were 43.5%, 87.0%, and 100%, respectively, at three months; furthermore, they were 78.3%, 100%, and 100% accordingly at six months. Moreover, most European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) subscales of functions (including physical and emotional function) and symptoms (including pain, nausea, and vomiting) were generally improved at three months (all P < 0.05). Furthermore, median progression-free survival (PFS) was 14.0 [95% confidence interval (CI): 10.4–17.6] months, with a 1-year PFS rate of 62.9%, but the 2-year PFS rate was not reached. Moreover, the median overall survival (OS) was 22.0 (95% CI: 16.8–27.2) months, with a 1-year OS rate of 91.3% and a 2-year OS rate of 43.5%. Additionally, the main adverse events included fever (100%), pain (65.2%), liver function impairment (65.2%), fatigue (56.5%), and nausea and vomiting (52.2%), which were all categorized as grade 1–2. Conclusion CSM-TACE plus 125I brachytherapy is effective and safe in patients with liver metastases from NSCLC after radical surgery, providing a potentially optimal option in these patients.
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Affiliation(s)
- Guangsheng Zhao
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Song Liu
- Cancer Interventional Center, Linyi Cancer Hospital, Linyi, China
| | - Ying Liu
- Hepatobiliary and Pancreatic Center, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Xiang Li
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Guangji Yu
- Cancer Interventional Center, Linyi Cancer Hospital, Linyi, China
| | - Yuewei Zhang
- Hepatobiliary and Pancreatic Center, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Jie Bian
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jianlin Wu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
- *Correspondence: Jun Zhou, ; Jianlin Wu, ; Fei Gao,
| | - Jun Zhou
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
- *Correspondence: Jun Zhou, ; Jianlin Wu, ; Fei Gao,
| | - Fei Gao
- Cancer Interventional Center, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Jun Zhou, ; Jianlin Wu, ; Fei Gao,
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Chen H, Teng M, Zhang H, Liang X, Cheng H, Liu G. Advanced radionuclides in diagnosis and therapy for hepatocellular carcinoma. CHINESE CHEM LETT 2022. [DOI: 10.1016/j.cclet.2022.03.079] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Wei S, Li C, Li M, Xiong Y, Jiang Y, Sun H, Qiu B, Lin CJ, Wang J. Radioactive Iodine-125 in Tumor Therapy: Advances and Future Directions. Front Oncol 2021; 11:717180. [PMID: 34660280 PMCID: PMC8514864 DOI: 10.3389/fonc.2021.717180] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/07/2021] [Indexed: 12/11/2022] Open
Abstract
Radioactive iodine-125 (I-125) is the most widely used radioactive sealed source for interstitial permanent brachytherapy (BT). BT has the exceptional ability to deliver extremely high doses that external beam radiotherapy (EBRT) could never achieve within treated lesions, with the added benefit that doses drop off rapidly outside the target lesion by minimizing the exposure of uninvolved surrounding normal tissue. Spurred by multiple biological and technological advances, BT application has experienced substantial alteration over the past few decades. The procedure of I-125 radioactive seed implantation evolved from ultrasound guidance to computed tomography guidance. Compellingly, the creative introduction of 3D-printed individual templates, BT treatment planning systems, and artificial intelligence navigator systems remarkably increased the accuracy of I-125 BT and individualized I-125 ablative radiotherapy. Of note, utilizing I-125 to treat carcinoma in hollow cavity organs was enabled by the utility of self-expandable metal stents (SEMSs). Initially, I-125 BT was only used in the treatment of rare tumors. However, an increasing number of clinical trials upheld the efficacy and safety of I-125 BT in almost all tumors. Therefore, this study aims to summarize the recent advances of I-125 BT in cancer therapy, which cover experimental research to clinical investigations, including the development of novel techniques. This review also raises unanswered questions that may prompt future clinical trials and experimental work.
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Affiliation(s)
- Shuhua Wei
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Chunxiao Li
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Mengyuan Li
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Yan Xiong
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Yuliang Jiang
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Haitao Sun
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | - Bin Qiu
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
| | | | - Junjie Wang
- Department of Radiation Oncology, Peking University 3rd Hospital, Beijing, China
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Wang HW, Li XJ, Li SJ, Lu JR, He DF. Biliary stent combined with iodine-125 seed strand implantation in malignant obstructive jaundice. World J Clin Cases 2021; 9:801-811. [PMID: 33585626 PMCID: PMC7852634 DOI: 10.12998/wjcc.v9.i4.801] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/23/2020] [Accepted: 12/10/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Malignant obstructive jaundice is mainly caused by cholangiocarcinoma. Only a few patients are indicated for surgical resection, and the 3-year survival rate is < 50%. For patients who are not eligible for surgery, biliary stent placement can relieve biliary obstruction and improve liver function and quality of life. However, restenosis after biliary stents has a poor prognosis and is a clinical challenge. Biliary stent combined with iodine-125 (125I) seed implantation can prolong stent patency and improve survival.
AIM To evaluate the safety and efficacy of biliary stent combined with 125I seed strand implantation in malignant obstructive jaundice.
METHODS We enrolled 67 patients between January 2016 and June 2018 with malignant obstructive jaundice and randomized them into a biliary stent combined with 125I seed strand treatment (combined) group (n = 32) and biliary stent (control) group (n = 35). All patients underwent enhanced computed tomography and magnetic resonance imaging and were tested for biochemical and cancer markers. Twelve patients underwent pathological examination before surgery. All patients were followed up by telephone or clinical visit. Postoperative liver function improvement, postoperative complications, stent patency time, and survival time were compared between the two groups. Prognostic risk factors were evaluated.
RESULTS Technical success was achieved in all patients in both groups. Postoperative liver function improved significantly in all patients (total bilirubin, direct bilirubin, alanine aminotransferase, and aspartate aminotransferase decreased significantly in all patients, the P values were less than 0.05). There was no significant difference in preoperative or postoperative indexes between the two groups for changes in total bilirubin (P = 0.147), direct bilirubin (P = 0.448), alanine aminotransferase (P = 0.120), and aspartate aminotransferase (P = 0.387) between the two groups. The median stent patency time of the combined group was 9.0 ± 1.4 mo [95% confidence interval (CI): 6.3-11.8 mo], which was significantly longer than the that of the control group (6.0 ± 0.3 mo, 95%CI: 5.5-6.5 mo, P = 0.000). The median survival time of the combined group was 11.0 ± 1.4 mo (95%CI: 8.2-13.7 mo), which was significantly longer than that of the control group (7.0 ± 0.3 mo, 95%CI: 6.4-7.6 mo, P = 0.000). Location of obstruction and number of stents were independent risk factors affecting prognosis.
CONCLUSION Biliary stent combined with 125I seed strand implantation is safe and effective in malignant obstructive jaundice and improves stent patency time and median survival time.
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Affiliation(s)
- Hui-Wen Wang
- Department of Interventional, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
| | - Xiao-Jing Li
- Department of Interventional, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
| | - Shi-Jie Li
- Department of Interventional, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
| | - Jun-Rong Lu
- Department of Interventional, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
| | - Dong-Feng He
- Department of Interventional, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
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The efficacy of the combination of percutaneous transhepatic biliary drainage and 125I stranded seeds for malignant bile duct obstruction treatment. J Contemp Brachytherapy 2020; 12:225-232. [PMID: 32695193 PMCID: PMC7366027 DOI: 10.5114/jcb.2020.96862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/22/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose To investigate the efficacy of percutaneous transhepatic biliary drainage (PTBD) combined with iodine-125 (125I) stranded seeds for the treatment of malignant bile duct obstruction (MBO). Material and methods A retrospective study was performed on 58 consecutive MBO patients. Twenty patients underwent PTBD combined with 125I stranded seeds (group A). Thirty-eight patients underwent percutaneous trans-hepatic biliary drainage (group B). Total bilirubin, direct bilirubin, and indirect bilirubin levels were compared preoperatively, 1-week, 1-month, and 3-months post-operatively. Carbohydrate antigen 19-9 (CA19-9), cancer antigen 125 (CA125), and carcino-embryonic antigen (CEA) levels were compared at preoperative and 3-month post-operative stages. The time free from biliary obstruction and survival times were compared. Results The differences in total bilirubin, direct bilirubin, and indirect bilirubin levels between the two groups were not significant preoperatively (p = 0.857, p = 0.719, and p = 0.870), and 1-week post-operatively (p = 0.259, p = 0.395, and p = 0.145). However, 1-month (p = 0.012, p = 0.005, and p = 0.049) and 3-months post-operatively (p < 0.001, p = 0.001, and p = 0.001), group A was lower than group B. Differences in CA19-9, CA125, and CEA levels between the two groups were not significant preoperatively (p = 0.229, p = 0.116, and p = 0.273) and 3-months post-operatively (p = 0.159, p = 0.342, and p = 0.306). The median biliary obstruction free time was 7.0 months for group A and 5.0 months for group B (p < 0.001). The median survival time was 9.0 months for group A and 6.0 months for group B (p = 0.001). Conclusions PTBD combined with 125I stranded seeds seem to reduce bilirubin levels and prevents biliary obstruction, promoting survival.
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Li J, Zhang L, Xie Q, Wang W, Hua Y, Zhou L, Sun Z. 125I seeds implantation for treating residual hepatocellular carcinoma located beneath the diaphragm after transcatheter arterial chemoembolization. Brachytherapy 2019; 18:420-425. [PMID: 30745017 DOI: 10.1016/j.brachy.2018.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/07/2018] [Accepted: 12/21/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE The effect of 125I seed implantation for the treatment of local residual tumor of hepatocellular carcinoma located beneath the diaphragm (HCC-LBD) after transcatheter arterial chemoembolization (TACE) has not yet been reported. This retrospective study was performed to evaluate the safety and efficacy of 125I seeds implantation (ISI) for the treatment of residual HCC-LBD after TACE. METHODS AND MATERIALS A total of 18 patients treated with ISI between August 2012 and March 2018 for residual HCC-LBD after single or multiple TACE were enrolled. Local control, survival, and postoperative complications were analyzed retrospectively. Overall followup time was displayed by survival curves. RESULTS The 18 patients received a total of 20 ISI treatments. The total number of seeds implanted was 650, with a mean of 36 ± 13 seeds per patients (range, 20-70). Mean D90 was 123 Gy. Complete response + partial response (CR + PR) was documented in 14, 16, and 16 of patients at 3, 6, and 12 months after implantation, respectively. In four patients, seeds implantation was performed through the diaphragm; two of these patients developed small pneumothoraces. Pulmonary compression of pneumothorax is less than 30% combined with a little blood in sputum, no chest tightness, shortness of breath, all symptoms subsided without interventions, and the patients were discharged after observation for 2 days. After the procedure, routine blood examination and liver and kidney function were normal. CONCLUSION The combination of TACE with ISI appears to be a safe and efficient treatment for residual HCC-BLD. IMPLICATIONS FOR PRACTICE This study evaluated the feasibility, safety, and short-term efficacy of ISI for local residual tumor of hepatocellular carcinoma located beneath the diaphragm (HCC-LBD) after TACE. Results suggest that residual tumor of HCC after TACE located in the posterosuperior part of the liver (segments seven and eight), laparoscopic liver resection, and alblation is difficult to perform and that as a supplement treatment, 125I seeds implantation is safe and easy accessible. TACE combined with 125I seeds has excellent local control effectiveness, and long-term efficacy and survival benefit still need to be more comprehensively evaluated.
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Affiliation(s)
- Jie Li
- Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Jiangsu Province, Wuxi, China.
| | - Lijuan Zhang
- Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, Wuxi, China
| | - Qigen Xie
- Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Jiangsu Province, Wuxi, China
| | - Weiguo Wang
- Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Jiangsu Province, Wuxi, China
| | - Yanyan Hua
- Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Jiangsu Province, Wuxi, China
| | - Leyuan Zhou
- Department of Radiotherapy, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Jiangsu Province, Wuxi, China
| | - Zongqiong Sun
- Department of Radiology, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Jiangsu Province, Wuxi, China
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Shih YH, Peng CL, Weng MF, Chiang PF, Luo TY, Lin XZ. Evaluation Efficacy of Rhenium-188-Loaded Micro-particles for Radiotherapy in a Mouse Model of Hepatocellular Carcinoma. Mol Pharm 2019; 16:1083-1091. [DOI: 10.1021/acs.molpharmaceut.8b01083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Ying-Hsia Shih
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan 32546, Taiwan
| | - Cheng-Liang Peng
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan 32546, Taiwan
| | - Mao-Feng Weng
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan 32546, Taiwan
| | - Ping-Fang Chiang
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan 32546, Taiwan
| | - Tsai-Yueh Luo
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan 32546, Taiwan
| | - Xi-Zhang Lin
- Department of Internal Medicine, National Cheng Kung University, Tainan 704, Taiwan
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