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Meng P, Ma JP, Huang XF, Zhang KL. Application of radioactive iodine-125 microparticles in hepatocellular carcinoma with portal vein embolus. World J Gastrointest Surg 2024; 16:2023-2030. [PMID: 39087134 PMCID: PMC11287696 DOI: 10.4240/wjgs.v16.i7.2023] [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] [Received: 05/02/2024] [Revised: 05/22/2024] [Accepted: 06/13/2024] [Indexed: 07/22/2024] Open
Abstract
BACKGROUND Radioactive iodine-125 (125I) microparticle therapy is a new type of internal radiation therapy that has shown unique advantages in the treatment of malignant tumors, especially hepatocellular carcinoma. Patients with hepatocellular carcinoma frequently experience portal vein embolism, which exacerbates the difficulty and complexity of treatment. 125I particles, used in local radiotherapy, can directly act on tumor tissue and reduce damage to surrounding healthy tissue. Through retrospective analysis, this study discussed the efficacy and safety of radioactive 125I particles in portal vein embolization patients with hepatocellular carcinoma in order to provide more powerful evidence supporting clinical treatment. AIM To investigate the effect of transcatheter arterial chemoembolization combined with portal vein 125I particle implantation in the treatment of primary liver cancer patients with portal vein tumor thrombus and its influence on liver function. METHODS The clinical data of 96 patients with primary liver cancer combined with portal vein tumor thrombus admitted to our hospital between January 2020 and December 2023 were retrospectively analyzed. Fifty-two patients received treatment with transcatheter arterial chemoembolization and implantation of 125I particles in the portal vein (combination group), while 44 patients received treatment with transcatheter arterial chemoembolization alone (control group). The therapeutic effects on tumor lesions, primary liver cancer, and portal vein tumor embolisms were compared between the two groups. Changes in relevant laboratory indexes before and after treatment were evaluated. The t test was used to compare the measurement data between the two groups, and the χ 2 test was used to compare the counting data between groups. RESULTS The tumor lesion response rate in the combination group (59.62% vs 38.64%) and the response rate of patients with primary liver cancer complicated with portal vein tumor thrombus (80.77% vs 59.09%) were significantly greater than those in the control group (χ 2 = 4.196, 5.421; P = 0.041, 0.020). At 8 wk after surgery, the serum alpha-fetoprotein, portal vein main diameter, and platelet of the combined group were significantly lower than those of the control group, and the serum alanine aminotransferase, aspartate aminotransferase, and total bilirubin were significantly greater than those of the control group (t = 3.891, 3.291, 2.330, 3.729, 3.582, 4.126; P < 0.05). The serum aspartate aminotransferase, alanine aminotransferase, and total bilirubin levels of the two groups were significantly greater than those of the same group 8 wk after surgery (P < 0.05), and the peripheral blood platelet, alpha-fetoprotein, and main portal vein diameter were significantly less than those of the same group before surgery (P < 0.05). CONCLUSION In patients with primary liver cancer and a thrombus in the portal vein, transcatheter arterial chemoembolization plus portal vein 125I implantation is more effective than transcatheter arterial chemoembolization alone. However, during treatment it is crucial to pay attention to liver function injury caused by transcatheter arterial chemoembolization.
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Affiliation(s)
- Peng Meng
- The Fourth Department of Oncology, Yantai Hospital of Traditional Chinese Medicine, Yantai 264001, Shandong Province, China
| | - Ji-Peng Ma
- Department of Medical Services, Yantai Hospital of Traditional Chinese Medicine, Yantai 264001, Shandong Province, China
| | - Xiao-Fei Huang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510062, Guangdong Province, China
| | - Kang-Le Zhang
- The Third Department of Oncology, Yantai Hospital of Traditional Chinese Medicine, Yantai 264001, Shandong Province, China
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Xu R, Chen J, Chen D, Zhang X, Cui W, Deng Y, Sun D, Yuan B, Li J. CT-guided Percutaneous Microwave Ablation Combined with Local Radiotherapy or Chemotherapy of Malignant Pulmonary Tumors. Curr Radiopharm 2024; 17:184-199. [PMID: 38204263 DOI: 10.2174/0118744710261655231214105406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/18/2023] [Accepted: 10/30/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND AND OBJECTIVE The study aimed to investigate the clinical efficacy of CT-guided microwave ablation (MWA) combined with 125I seed implantation or bronchial arterial infusion (BAI) chemotherapy in the treatment of malignant pulmonary tumors. METHODS A total of 56 patients who underwent MWA, MWA combined with 125I particle implantation, or MWA combined with BAI chemotherapy for advanced lung cancer or metastatic lung cancer from January 2015 to June 2021 in Guangdong Provincial People's Hospital were enrolled. Among them, 21 patients were treated with MWA (MWA), 18 with MWA combined with 125I seed implantation (MWA+125I), and 17 with MWA combined with BAI chemotherapy (MWA+BAI). The short-term outcomes, complications, Eastern Cooperative Oncology Group (ECOG) performance score (Zubrod-ECOG-WHO, ZPS), survival, and factors related to survival were compared between the three groups. RESULTS The response rate of the MWA group (9.52%) was significantly lower than that of the MWA+125I group (50.00%) and MWA+BAI chemotherapy group (47.06%), and the differences were statistically significant (p < 0.05). The incidence of complications in the MWA, MWA+125I, and MWA+BAI chemotherapy groups was 47.62%, 55.56%, and 52.94%, respectively, with no significant difference (p > 0.05). Three months after the treatment, the ZPS of the MWA+125I and MWA+BAI chemotherapy groups was significantly lower than before treatment and significantly lower than that of the MWA group in the same period; the differences were statistically significant (p < 0.05). The median survival time of the MWA+125I group was 18 (9.983, 26.017) months and that of the MWA+BAI chemotherapy group was 21 (0.465, 41.535) months, both of which were higher than that of the MWA group [11 (6.686, 15.314) months]; the differences were statistically significant (p < 0.05). Cox regression analysis was performed on the factors related to survival and revealed treatment mode as a protective factor [HR = 0.433, 95% CI = (0.191, 0.984), p = 0.046]. Other factors, such as gender, age, and tumor size, did not independently affect survival. CONCLUSION CT-guided MWA combined with 125I seed implantation and MWA combined with BAI chemotherapy are safe and effective for the treatment of advanced lung cancer and metastatic lung cancer, and can control tumor progression and prolong survival time.
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Affiliation(s)
- Rongde Xu
- Department of Interventional Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China
| | - Jingjing Chen
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China
| | - Daohua Chen
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510080, China
| | - Xiaobo Zhang
- School of Automation, Guangdong University of Technology, Guangzhou, Guangdong, 510006, China
| | - Wei Cui
- Department of Interventional Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China
| | - Yi Deng
- Department of Pulmonary and Critical Care Medicine, The First People's Hospital of Yunnan Province. The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650000, China
- Medical School, Kunming University of Science and Technology, Kunming, Yunnan, 650000, China
| | - Danxiong Sun
- Department of Pulmonary and Critical Care Medicine, The First People's Hospital of Yunnan Province. The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650000, China
| | - Bing Yuan
- Department of Pulmonary and Critical Care Medicine, The First People's Hospital of Yunnan Province. The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650000, China
| | - Jing Li
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China
- Department of Pulmonary and Critical Care Medicine, The First People's Hospital of Yunnan Province. The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650000, China
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Yuan Q, Ma Y, Wu L, Song Y, He C, Huang X, Yang C, Liu B, Han H, Zhang K, Wang J. Clinical Outcome of CT-Guided Iodine-125 Radioactive Seed Implantation for Intrahepatic Recurrent Hepatocellular Carcinoma: A Retrospective, Multicenter Study. Front Oncol 2022; 12:819934. [PMID: 35463334 PMCID: PMC9024337 DOI: 10.3389/fonc.2022.819934] [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: 11/22/2021] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
Abstract
The efficacy and safety of CT-Guided Iodine-125 Radioactive Seed Implantation (RSI) for the treatment of intrahepatic recurrent hepatocellular carcinoma (rHCC) were analyzed in this multicenter retrospective study. We reviewed the medical records of patients with rHCC treated with I-125 seed implantation at four different hospitals in China from December 2011 and January 2021. The local progression-free survival (LPFS),liver PFS, and overall survival (OS) were calculated, and the short-term efficacy and treatment-related toxicities were evaluated. A total of 82 patients were enrolled; the median follow-up time was 46 months (range, 3–80 months). The 1-, 3- and 5-year LPFS rates were 63.8%, 27.1%, and 7.9%, respectively, and the corresponding OS rates were 74.8%, 32.9%, and 12.6%, respectively. Univariate analysis showed that factors influencing LPFS included the maximum lesion diameter, Barcelona Clinic Liver Cancer (BCLC) stage, interval between treatment and recurrence, and D90. Multivariate analyses revealed that the BCLC stage, interval between treatment and recurrence, and D90 were independent factors influencing LPFS, whereas BCLC stage, D90, and short-term efficacy were independent factors influencing OS. In summary, I-125 seed implantation is a safe and effective treatment for rHCC. The BCLC stage, interval, and D90 were found to influence the local control. A larger, prospective study is required to confirm the dose-response curve for Iodine-125 RSI of rHCC.
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Affiliation(s)
- Qianqian Yuan
- Department of Oncology, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Yanli Ma
- Department of Oncology, Staff Hospital of Chengde Iron and Steel Group Co. Ltd., Chengde, China
| | - Linlin Wu
- Department of Oncology, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Yuqing Song
- Department of Oncology, Staff Hospital of Chengde Iron and Steel Group Co. Ltd., Chengde, China
| | - Chuang He
- Department of Nuclear Medicine, Southwest Hospital, Army Medical University, Chongqing, China
| | - Xuequan Huang
- Department of Nuclear Medicine, Southwest Hospital, Army Medical University, Chongqing, China
| | - Chongshuang Yang
- Department of Nuclear Medicine, Southwest Hospital, Army Medical University, Chongqing, China
| | - Bin Liu
- Department of Surgery, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Hongmei Han
- Department of Radiation Oncology, The First People’s Hospital of Keerqin District, Tongliao, China
| | - Kaixian Zhang
- Department of Oncology, Tengzhou Central People’s Hospital, Zaozhuang, China
- *Correspondence: Kaixian Zhang, ; Junjie Wang,
| | - Junjie Wang
- Department of Radiation Oncology, Peking University Third Hospital, Beijing, China
- *Correspondence: Kaixian Zhang, ; Junjie Wang,
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Radu C, Fisher P, Mitrea D, Birlescu I, Marita T, Vancea F, Florian V, Tefas C, Badea R, Ștefănescu H, Nedevschi S, Pisla D, Hajjar NA. Integration of Real-Time Image Fusion in the Robotic-Assisted Treatment of Hepatocellular Carcinoma. BIOLOGY 2020; 9:biology9110397. [PMID: 33198415 PMCID: PMC7697343 DOI: 10.3390/biology9110397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/23/2020] [Accepted: 11/11/2020] [Indexed: 12/19/2022]
Abstract
Simple Summary Hepatocellular carcinoma is one of the leading causes of cancer-related deaths worldwide. An image fusion system is developed for the robotic-assisted treatment of hepatocellular carcinoma, which is not only capable of imaging data interpretation and reconstruction, but also automatic tumor detection. The optimization and integration of the image fusion system within a novel robotic system has the potential to demonstrate the feasibility of the robotic-assisted targeted treatment of hepatocellular carcinoma by showing benefits such as precision, patients safety and procedure ergonomics. Abstract Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths worldwide, with its mortality rate correlated with the tumor staging; i.e., early detection and treatment are important factors for the survival rate of patients. This paper presents the development of a novel visualization and detection system for HCC, which is a composing module of a robotic system for the targeted treatment of HCC. The system has two modules, one for the tumor visualization that uses image fusion (IF) between computerized tomography (CT) obtained preoperatively and real-time ultrasound (US), and the second module for HCC automatic detection from CT images. Convolutional neural networks (CNN) are used for the tumor segmentation which were trained using 152 contrast-enhanced CT images. Probabilistic maps are shown as well as 3D representation of HCC within the liver tissue. The development of the visualization and detection system represents a milestone in testing the feasibility of a novel robotic system in the targeted treatment of HCC. Further optimizations are planned for the tumor visualization and detection system with the aim of introducing more relevant functions and increase its accuracy.
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Affiliation(s)
- Corina Radu
- Regional Institute of Gastroenterology and Hepatology Prof. Dr. O.Fodor, 400162 Cluj-Napoca, Romania; (C.R.); (P.F.); (C.T.); (H.Ș.); (N.A.H.)
- Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania;
| | - Petra Fisher
- Regional Institute of Gastroenterology and Hepatology Prof. Dr. O.Fodor, 400162 Cluj-Napoca, Romania; (C.R.); (P.F.); (C.T.); (H.Ș.); (N.A.H.)
| | - Delia Mitrea
- Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.M.); (T.M.); (F.V.); (V.F.); (S.N.)
| | - Iosif Birlescu
- Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.M.); (T.M.); (F.V.); (V.F.); (S.N.)
- Correspondence: (I.B.); (D.P.)
| | - Tiberiu Marita
- Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.M.); (T.M.); (F.V.); (V.F.); (S.N.)
| | - Flaviu Vancea
- Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.M.); (T.M.); (F.V.); (V.F.); (S.N.)
| | - Vlad Florian
- Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.M.); (T.M.); (F.V.); (V.F.); (S.N.)
| | - Cristian Tefas
- Regional Institute of Gastroenterology and Hepatology Prof. Dr. O.Fodor, 400162 Cluj-Napoca, Romania; (C.R.); (P.F.); (C.T.); (H.Ș.); (N.A.H.)
- Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania;
| | - Radu Badea
- Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania;
| | - Horia Ștefănescu
- Regional Institute of Gastroenterology and Hepatology Prof. Dr. O.Fodor, 400162 Cluj-Napoca, Romania; (C.R.); (P.F.); (C.T.); (H.Ș.); (N.A.H.)
| | - Sergiu Nedevschi
- Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.M.); (T.M.); (F.V.); (V.F.); (S.N.)
| | - Doina Pisla
- Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania; (D.M.); (T.M.); (F.V.); (V.F.); (S.N.)
- Correspondence: (I.B.); (D.P.)
| | - Nadim Al Hajjar
- Regional Institute of Gastroenterology and Hepatology Prof. Dr. O.Fodor, 400162 Cluj-Napoca, Romania; (C.R.); (P.F.); (C.T.); (H.Ș.); (N.A.H.)
- Iuliu Hatieganu University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania;
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