Original Article
Radioactive I-125 seed implantation in treatment of TACE-refractory hepatocellular carcinoma
Wu Jingqiang, Huang Wensou, Guo Yongjian, Zhou Jingwen, Cai Mingyue, Liang Licong, Huang Jingjun, Lian Hui, He Mingji, Zhu Kangshun
Published 2021-08-28
Cite as Chin J Hepatobiliary Surg, 2021, 27(8): 570-574. DOI: 10.3760/cma.j.cn113884-20201102-00571
Abstract
ObjectiveTo study the use of radioactive I-125 seed implantation in the treatment of transarterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC).
MethodsA retrospective study was conducted on 70 patients with HCC who were initially treated with TACE between July 1, 2016 and August 31, 2019 at the Second Affiliated Hospital of Guangzhou Medical University. After these patients were found to be refractory to TACE, 29 patients were converted to radioactive I-125 seed implantation (the 125I seed group), and 41 patients were continued with TACE (the TACE group). The objective response rate, progression-free survival (PFS), overall survival (OS), total overall survival (TOS) of the two groups were compared.
ResultsThere were 59 males and 11 females, aged (60.5±11.9 ) years in this study. At 1, 3, 6 months after treatment, the objective response rates of the 125I seed group were 20.7%, 40.7%, 34.6%, respectively, which were significantly higher than that of the TACE group of 2.6%, 3.3%, 5.0%, respectively. The PFS, OS, TOS in the 125I seed group were 7.6, 21.1, 32.1 months, respectively, which were significantly better when compared with the TACE group (3.5, 8.5, 14.8 months, respectively, all P<0.05). There was no significant difference in the embolization syndrome between the two groups [93.1%(27/29) vs 100.0%(41/41),P>0.05]. Child-Pugh B grading (HR=0.311, 95%CI: 0.160-0.603, P=0.005) and TACE (HR=0.308, 95%CI: 0.159-0.597, P=0.002) were independent risk prognostic factors for survival.
ConclusionThis study showed better treatment efficacy and safety using radioactive I-125 seed implantation in TACE-refractory HCC and this treatment significantly improved survival of patients when compared with TACE alone.
Key words:
Carcinoma, hepatocellular; Brachytherapy; 125I radioactive seeds
Contributor Information
Wu Jingqiang
Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
Huang Wensou
Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
Guo Yongjian
Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
Zhou Jingwen
Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
Cai Mingyue
Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
Liang Licong
Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
Huang Jingjun
Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
Lian Hui
Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
He Mingji
Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
Zhu Kangshun
Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
