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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. [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 χ2 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 (χ2 = 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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Wang YB, Zhang W, Bao L, Lu Y, Hong J. Transarterial chemoembolization with insertion of radioactive seeds for hepatocellular carcinoma. Wideochir Inne Tech Maloinwazyjne 2023; 18:645-654. [PMID: 38239583 PMCID: PMC10793153 DOI: 10.5114/wiitm.2023.131539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/03/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction For patients diagnosed with hepatocellular carcinoma (HCC) not eligible for surgical tumor resection, transarterial chemoembolization (TACE) is commonly employed as a therapeutic strategy. After TACE is complete, a variety of other therapeutic approaches can be employed to improve patient overall survival (OS) and progression-free survival (PFS). Aim This study was developed with the goal of comparing the relative clinical efficacy and long-term outcomes observed in HCC patients who underwent combination TACE and radioactive seed insertion (RSI) treatment to those of patients who only underwent TACE treatment. Material and methods This retrospective analysis included a total of 80 patients with HCC who underwent treatment via TACE with (n = 39) or without (n = 41) RSI. Treatment responses and long-term outcomes in these two groups were compared with one another. Results The baseline characteristics of both groups were comparable. None of the patients experienced adverse complications related to treatment. Individuals in the combination treatment group experienced complete response (59.0% vs. 22.0%, p = 0.001) and total response (92.3% vs. 58.5%, p = 0.001) rates that were significantly better than those of patients that underwent TACE alone. Combination treatment was also associated with significant prolongation of patient PFS (13 vs. 7 months, p = 0.019) and OS (23 vs. 15 months, p = 0.005), with Cox regression analyses identifying combination treatment as a predictor of prolonged PFS and OS. Conclusions These data suggest that a combination of TACE and RSI can contribute to significant improvements in HCC patient therapeutic response rates, OS, and PFS relative to TACE alone.
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Affiliation(s)
- You-Bin Wang
- Department of Interventional Radiology, Xuzhou Cancer Hospital, Xuzhou, China
| | - Wei Zhang
- Department of Liver Disease, Daxing Hospital, Xi’an, China
| | - Le Bao
- Department of Interventional Radiology, Xuzhou Cancer Hospital, Xuzhou, China
| | - Yun Lu
- Department of Radiology, Xuzhou Central Hospital, Xuzhou, China
| | - Jiao Hong
- Department of Radiology, Xuzhou Central Hospital, Xuzhou, China
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Guo Y, Wu J, Liang L, Zhu K, Zhou J, Lin L, Chen Y, Cao B, He M, Lian H, Huang W, Cai M. Tyrosine-kinase inhibitor combined with iodine-125 seed brachytherapy for hepatocellular carcinoma refractory to transarterial chemoembolization: a propensity-matched study. Cancer Imaging 2023; 23:91. [PMID: 37749616 PMCID: PMC10518921 DOI: 10.1186/s40644-023-00604-4] [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: 03/29/2023] [Accepted: 08/27/2023] [Indexed: 09/27/2023] Open
Abstract
PURPOSE To investigate the efficacy and safety of tyrosine-kinase inhibitor (TKI) combined with iodine-125 seed brachytherapy (TKI-I) versus TKI alone for patients with hepatocellular carcinoma (HCC) refractory to transarterial chemoembolization (TACE). METHODS Data of patients with TACE-refractory HCC who received TKI (sorafenib or lenvatinib) or TKI-I from September 2018 to December 2020 were retrospectively analyzed. A propensity score matching (PSM) was performed to diminish potential bias. The primary endpoints were overall survival (OS) and time to progression (TTP). Tumor responses and treatment-related adverse events (TRAEs) were also compared between the two groups. RESULTS A total of 132 patients were included in this study. Under PSM, 48 paired patients were selected for comparison. The median OS was 23.2 (95% CI 20.9-25.1) months in the TKI-I group versus 13.9 (95% CI 11.1-16.7) months in the TKI group (P < 0.001). The median TTP was 12.8 (95% CI 10.1-15.5) months in the TKI-I group versus 5.8 (95% CI 5.0-6.6) months in the TKI group (P < 0.001). Patients in the TKI-I group had higher objective response rate (68.8% vs. 33.3%, P = 0.001) and disease control rate (89.6% vs. 66.7%, P = 0.007) than those in the TKI group. The incidence and severity of TRAEs in the TKI-I group were comparable to those in the TKI group (any grade, 89.7% vs. 92.2%, P = 0.620; ≥grade 3, 33.8% vs. 32.8%, P = 0.902). CONCLUSIONS TKI-I was safe and significantly improved survival over TKI alone in HCC patients with TACE refractoriness.
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Affiliation(s)
- Yongjian Guo
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jingqiang Wu
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Licong Liang
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Kangshun Zhu
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jingwen Zhou
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Liteng Lin
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ye Chen
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Bihui Cao
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Mingji He
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hui Lian
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Wensou Huang
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
| | - Mingyue Cai
- Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
- Radiology Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
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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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Cao S, Lyu T, Fan Z, Guan H, Song L, Tong X, Wang J, Zou Y. Long-term outcome of percutaneous radiofrequency ablation for periportal hepatocellular carcinoma: tumor recurrence or progression, survival and clinical significance. Cancer Imaging 2022; 22:2. [PMID: 34983650 PMCID: PMC8725335 DOI: 10.1186/s40644-021-00442-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/08/2021] [Indexed: 02/08/2023] Open
Abstract
Background/aim Recent studies have suggested that periportal location of percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is considered as one of the independent risk factors for local tumor progression (LTP). However, the long-term therapeutic outcomes of percutaneous RFA as the first-line therapy for single periportal HCCand corresponding impacts on tumor recurrence or progression are still unclear. Materials and methods From February 2011 to October 2020, a total of 233 patients with single nodular HCC ≤ 5 cm who underwent RFA ± transarterial chemoembolization (TACE) as first-line therapy was enrolled and analyzed, including 56 patients in the periportal group and 177 patients in the nonperiportal group. The long-term therapeutic outcomes between the two groups were compared, risk factors of tumor recurrence or progression were evaluated. Results The LTP rates at 1, 3, and 5 years were significantly higher in the periportal group than those in the nonperiportal group (15.7, 33.7, and 46.9% vs 6.0, 15.7, and 28.7%, respectively, P = 0.0067). The 1-, 3- and 5-year overall survival (OS) rates in the periportal group were significantly worse than those in the nonperiportal group (81.3, 65.1 and 42.9% vs 99.3, 90.4 and 78.1%, respectively, P<0.0001). In the subgroup of single HCC ≤ 3 cm, patients with periportal HCC showed significantly worse LTP P = 0.0006) and OS (P<0.0001) after RFA than patients with single nonperiportal HCC; The univariate and multivariate analyses revealed that tumor size, periportal HCC and AFP ≥ 400ug/ml were independent prognostic factors for tumor progression after RFA. Furthermore, patients with single periportal HCC had significantly higher risk for IDR(P = 0.0012), PVTT(P<0.0001) and extrahepatic recurrence(P = 0.0010) after RFA than those patients with single nonperiportal HCC. . Conclusion The long-term therapeutic outcomes of RFA as the first-line therapy for single periportal HCC were worse than those for single nonperiportal HCC, an increased higher risk of tumor recurrence or progression after RFA was significantly associated with periportal HCC. Supplementary Information The online version contains supplementary material available at 10.1186/s40644-021-00442-2.
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Affiliation(s)
- Shoujin Cao
- Department of Interventional and Vascular Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Tianshi Lyu
- Department of Interventional and Vascular Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Zeyang Fan
- Department of Interventional and Vascular Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Haitao Guan
- Department of Interventional and Vascular Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Li Song
- Department of Interventional and Vascular Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Xiaoqiang Tong
- Department of Interventional and Vascular Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China
| | - Jian Wang
- Department of Interventional and Vascular Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| | - Yinghua Zou
- Department of Interventional and Vascular Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
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