Therapeutic effect of transcatheter arterial chemoembolization combined with iodine-125 seed strand implantation for treating hepatocellular carcinoma with portal vein tumor thrombus

Q4 Medicine

中华肝胆外科杂志 Pub Date : 2019-12-28 DOI:10.3760/CMA.J.ISSN.1007-8118.2019.12.002

Liangen Yang, Yu-ming Gu, Hao Xu, Xun Wang, Jiao-feng Lu

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引用次数: 0

Abstract

Objective To study the efficacy of combined transcatheter arterial chemoembolization (TACE) with iodine-125 seed implantation in treating hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). Methods From January 2015 to January 2019, eighty patients with HCC and PVTT who were treated at Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. A total of 71 patients were male and 9 were female, aged (53.1±9.9) years. The patients included 48 patients (group A) who were treated with TACE alone and 32 patients (group B) with TACE combined with iodine-125 seed implantation. The survival time and disease control rate (DCR) of the intrahepatic lesions and PVTT in the two groups were compared. Results There were 32 patients who were successfully implanted with portal vein iodine-125 seed and stents. The DCR of PVTT in group B was significantly better than in group A (90.6% vs. 81.3%, P 0.05). The survival times of group A and group B were (8.0±0.6) and (16.0±2.1) months, respectively. The median survival times were (7.6±1.0) and (14.8±1.5) months respectively. Group B had significantly better survival time than Group A, (both P<0.05). Univariate and multivariate analysis showed that tumor size was an independent risk factor of prognosis (Regression coefficient: 0.960, HR: 0.383, 95% CI: 0.158-0.926, P<0.05). 125I treatment was a protective factor of prognosis (Regression coefficient: -1.525, HR: 0.218, 95% CI: 0.100-0.473, P<0.05). Conclusion For patients with HCC and PVTT, compared with TACE alone, TACE combined with iodine-125 seed implantation could safely and effectively control portal vein tumor thrombus, and prolonged patient survival. Key words: Carcinoma, hepatocellular; Portal vein tumor thrombus; Transcatheter arterial chemoembolization; Iodine radioisotopes

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经导管动脉化疗栓塞联合碘-125种子束植入治疗肝细胞癌伴门静脉癌栓的疗效观察

目的探讨经导管动脉化疗栓塞(TACE)联合125碘粒子植入治疗肝癌合并门静脉肿瘤血栓(PVTT)的疗效。方法对2015年1月至2019年1月徐州医科大学附属医院收治的80例HCC合并PVTT患者进行回顾性分析。男性71例，女性9例，年龄(53.1±9.9)岁。其中单独TACE治疗48例(A组)，TACE联合碘125粒子植入术32例(B组)。比较两组患者肝内病变的生存时间、疾病控制率(DCR)及PVTT。结果32例患者成功植入门静脉125碘粒子及门静脉支架。B组PVTT DCR显著优于A组(90.6% vs 81.3%， P < 0.05)。A组和B组的生存时间分别为(8.0±0.6)个月和(16.0±2.1)个月。中位生存期分别为(7.6±1.0)个月和(14.8±1.5)个月。B组的生存时间显著高于A组(P<0.05)。单因素及多因素分析显示，肿瘤大小是影响预后的独立危险因素(回归系数:0.960,HR: 0.383, 95% CI: 0.158 ~ 0.926, P<0.05)。125I治疗是预后的保护因素(回归系数:-1.525,HR: 0.218, 95% CI: 0.100 ~ 0.473, P<0.05)。结论对于HCC合并PVTT患者，与单用TACE相比，TACE联合碘125粒子植入术能安全有效地控制门静脉肿瘤血栓形成，延长患者生存期。关键词:肝癌;肝细胞癌;门静脉肿瘤血栓;经导管动脉化疗栓塞;碘的放射性同位素

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来源期刊

中华肝胆外科杂志 Medicine-Gastroenterology

CiteScore

0.20

自引率

0.00%

发文量

7101

期刊介绍： Chinese Journal of Hepatobiliary Surgery is an academic journal organized by the Chinese Medical Association and supervised by the China Association for Science and Technology, founded in 1995. The journal has the following columns: review, hot spotlight, academic thinking, thesis, experimental research, short thesis, case report, synthesis, etc. The journal has been recognized by Beida Journal (Chinese Journal of Humanities and Social Sciences). Chinese Journal of Hepatobiliary Surgery has been included in famous databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Source Journals of China Science Citation Database (with Extended Version) and so on, and it is one of the national key academic journals under the supervision of China Association for Science and Technology.