Clinical Investigation
Efficacy and prognostic factors analysis of CT-guided 125I seeds implantation for primary hepatocellular carcinoma
Yuan Qianqian, Hu Miaomiao, Ma Yanli, Song Yuqing, He Chuang, Huang Xuequan, Yang Chongshuang, Zhu He, Wang Zhe, Zhang Kaixian, Wang Junjie, Zhang Jiuyan, Liu Bin
Published 2022-11-25
Cite as Chin J Nucl Med Mol Imaging, 2022, 42(11): 666-671. DOI: 10.3760/cma.j.cn321828-20210421-00133
Abstract
ObjectiveTo evaluate the efficacy and prognostic factors of 125I seeds implantation for primary hepatocellular carcinoma.
MethodsFrom December 2011 to January 2021, 102 primary hepatocellular carcinoma patients (86 males, 16 females; median age 61 years) who underwent 125I seeds implantation from 5 hospitals in China were enrolled in this retrospective study. Local progression-free survival (LPFS), overall survival (OS) and the prognostic factors were analyzed. Kaplan-Meier method was used to draw the distribution curve of survival time, and LPFS rate and OS rate were calculated. Log-rank test and Cox regression were used to analyze the influencing factors of survival.
ResultsThe median follow-up time was 38 months until April 2021. The local control rate was 96.1%(98/102). The 1-, 3- and 5-year LPFS rate were 61.3%, 25.5% and 12.7%, and the 1-, 3- and 5-year OS rate were 73.9%, 39.1% and 22.6%, respectively. There were 75 patients with progressive disease, including 42 patients with intrahepatic recurrence and metastasis after seed implantation, and 55 patients died. Multivariate analyses showed that short-term efficacy complete response (CR) (hazard ratio (HR)=0.34, 95% CI: 0.20-0.58) was protective factor related to LPFS; short-term efficacy CR (HR=0.25, 95% CI: 0.13-0.47) was the protective factors related to OS; Barcelona clinic liver cancer (BCLC) C stage (HR=2.33, 95% CI: 1.27-4.27), intrahepatic progression and extrahepatic metastasis (HR=3.18, 95% CI: 1.28-7.86; HR=3.23, 95% CI: 1.27-8.21) were independent risk factors related to OS. No sever adverse effects were observed.
Conclusions125I seeds implantation is safe and effective for the treatment of primary hepatocellular carcinoma. BCLC stage, short-term efficacy and post-implantation progression are independent factors related to survival time.
Key words:
Liver neoplasms; Brachytherapy; Iodine radioisotopes; Tomography, X-ray computed; Prognosis
Contributor Information
Yuan Qianqian
Department of Oncology, Tengzhou Central People′s Hospital, Tengzhou 277500, China
Hu Miaomiao
Department of Oncology, Tengzhou Central People′s Hospital, Tengzhou 277500, China
Ma Yanli
Department of Oncology, the Worker′s Hospital of Chengde Iron and Steel Limited Company, Chengde 067102, China
Song Yuqing
Department of Oncology, the Worker′s Hospital of Chengde Iron and Steel Limited Company, Chengde 067102, China
He Chuang
Department of Nuclear Medicine, Southwest Hospital, Army Medical University, Chongqing 400038, China
Huang Xuequan
Department of Nuclear Medicine, Southwest Hospital, Army Medical University, Chongqing 400038, China
Yang Chongshuang
Department of Nuclear Medicine, Southwest Hospital, Army Medical University, Chongqing 400038, China
Zhu He
Department of Oncology, Shanxi Hospital of Integrated Traditional and Western Medicine, Taiyuan 030013, China
Wang Zhe
Department of Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China
Zhang Kaixian
Department of Oncology, Tengzhou Central People′s Hospital, Tengzhou 277500, China
Wang Junjie
Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China
Zhang Jiuyan
Department of Clinical Pharmacy, Tengzhou Central People′s Hospital, Tengzhou 277500, China
Liu Bin
Department of Surgery, Tengzhou Central People′s Hospital, Tengzhou 277500, China
