To investigate the clinical value of ¹²⁵I seeds implantation in the treatment of primary liver cancer with portal vein tumor thrombus.

A total of 218 patients (184 males and 34 females, age: (53.8±9.2) years) with primary liver cancer with portal vein tumor thrombus between January 2015 and June 2018 were retrospectively analyzed. All patients underwent ¹²⁵I seeds implantation under CT guidance. CT examination and liver function test were repeated 2-3 months after the implantation, and the portal vein tumor thrombus diameter, liver function parameters and ascites before and after treatment were compared. All patients were followed up for 2-26 months and the survival time were calculated. Paired t test was used for data analysis.

Among 218 patients, 8 patients (3.7%) had complete remission of tumor thrombus, 111 patients (50.9%) had partial remission, 80 patients (36.7%) had no change, and 19 patients (8.7%) had disease progression 2-3 months after the implantation. The total effective rate was 91.3%(199/218). The diameter of tumor thrombus after treatment was (12.63±4.64) mm, which was significantly smaller than that before treatment ((26.65±10.88) mm; t=18.74, P<0.01); serum bilirubin, the direct bilirubin after treatment were different compared with those before treatment: (20.59±10.29) vs (24.27±12.65) pg/L (t=5.37, P<0.05), (11.40±8.37) vs (15.64±7.99) pg/L (t=8.44, P<0.05); the indirect bilirubin after treatment was not significantly different from that before treatment (t=0.85, P>0.05). Ascites in 86/142 patients were better after the implantation. No serious complications associated with treatment were seen. There were 162 patients died and 56 patients survived till the end of follow-up. The survival time of all patients was (9.23±0.59) months.

¹²⁵I seeds implantation can safely and effectively treat the portal vein tumor thrombus in patients with primary liver cancer, and improve the clinical symptoms such as ascites.

Liver neoplasms; Thrombosis; Portal vein; Brachytherapy; Iodine radioisotopes