Intraluminal brachytherapy using 125I seed strand combined with PTBD and Hepatic arterial infusion chemotherapy for unresectable Bismuth-Corlette III and IV stage hilar cholangiocarcinoma

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2025-03-05 DOI:10.1016/j.brachy.2024.12.004

Zi-Han Zhang , Min Li , Hui-Yi Sun , Fei-Hang Wang , Min-Jie Yang , Zhi-Ping Yan , Fu-You Li , Ling-Xiao Liu

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引用次数: 0

Abstract

PURPOSE

To evaluate the safety and efficacy of ¹²⁵I seed strand combined with percutaneous transhepatic biliary drainage (PTBD) and hepatic arterial infusion chemotherapy (HAIC) for unresectable Bismuth–Corlette III and IV stage hilar cholangiocarcinoma (HCCA).

METHODS

From January 2018 to December 2021, a total of 128 Bismuth–Corlette III and IV stage HCCA patients with obstructive jaundice were included in this single-center retrospective study. Forty-eight patients underwent ¹²⁵I seed strand combined with PTBD and HAIC (group A). The mean intended dose (r = 10 mm; z = 0; 240 days) in group A was 63.8 ± 0.6 Gy. Eighty cases underwent PTBD plus HAIC (group B). Median overall survival (OS) and median bile duct patency time (BDPT) were compared between the two groups.

RESULTS

In the propensity-score matched (PSM) cohort, the median OS and median BDPT were significantly longer in group A than in group B (44 PSM pairs; OS, 13.6 ± 0.4 vs. 8.7 ± 1.4 months, p < 0.001; BDPT, 12.1 ± 0.5 vs. 6.4 ± 0.7 months, p < 0.001). Multivariate analysis revealed that the treatment regimen was an independent prognostic factor of OS. There were no serious complications related to ¹²⁵I seed strand implantation.

CONCLUSIONS

¹²⁵I seed strand combined with PTBD and HAIC for unresectable Bismuth–Corlette III and IV stage HCCA is safe and effective.

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125I种子链腔内近距离化疗联合PTBD和肝动脉输注化疗治疗不可切除的Bismuth-Corlette III期和IV期肝门部胆管癌。

目的：评价125I种子链联合经皮经肝胆道引流（PTBD）和肝动脉输注化疗（HAIC）治疗无法切除的Bismuth-Corlette III期和IV期肝门级胆管癌（HCCA）的安全性和有效性。方法：2018年1月至2021年12月，128例Bismuth-Corlette III期和IV期HCCA合并梗阻性黄疸患者纳入单中心回顾性研究。48例患者接受125I种子链联合PTBD和HAIC （A组）。平均预期剂量(r = 10 mm；z = 0;A组为63.8 ± 0.6 Gy。80例患者行PTBD + HAIC （B组）。比较两组患者的中位总生存期（OS）和中位胆管通畅时间（BDPT）。结果：在倾向评分匹配（PSM）队列中，A组的中位OS和中位BDPT明显长于B组(44对PSM；13.6操作系统, ±0.4  vs。8.7 ± 1.4个月，p 125I粒子束植入。结论：125I种子链联合PTBD和HAIC治疗无法切除的Bismuth-Corlette III期和IV期HCCA安全有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.