Brachytherapy with Iodine-125 seeds for treatment of portal vein-branch tumor thrombus in patients with hepatocellular carcinoma

Autor:	Xiaoting Wan, Haibo Shao, Yi Zhou, Hongying Su, Duo Hong
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Male Cancer Research medicine.medical_specialty Carcinoma Hepatocellular Multivariate analysis Percutaneous Hepatocellular carcinoma medicine.medical_treatment Brachytherapy chemistry.chemical_element Iodine Gastroenterology Iodine Radioisotopes Surgical oncology Internal medicine Genetics Humans Medicine Chemoembolization Therapeutic Adverse effect Ultrasonography Interventional RC254-282 Retrospective Studies Venous Thrombosis Portal vein branch tumor thrombosis Portal Vein business.industry Liver Neoplasms Ultrasound Neoplasms. Tumors. Oncology. Including cancer and carcinogens Middle Aged medicine.disease Combined Modality Therapy Progression-Free Survival Treatment Outcome Oncology chemistry Iodine-125 seeds Multivariate Analysis Female business Research Article
Zdroj:	BMC Cancer, Vol 21, Iss 1, Pp 1-11 (2021) BMC Cancer
ISSN:	1471-2407
Popis:	Background There is currently no widely-accepted consensus for the management of hepatocellular carcinoma with portal vein tumor thrombus. We evaluate the safety and efficacy of ultrasound-guided percutaneous brachytherapy with iodine-125 seeds for the treatment of hepatocellular carcinoma with portal vein-branch tumor thrombus (PVBTT). Methods Sixty-nine hepatocellular carcinoma patients with PVBTT were enrolled; 34 received transarterial chemoembolization (TACE) combined with iodine-125 seeds implanted in the PVBTT; 35 were treated with TACE alone. Adverse events, objective response rate, disease control rate, progression-free survival, and overall survival were compared between the two groups. Tumor responses of PVBTT and intrahepatic tumor were correlated. Multivariate and subgroup analyses were conducted for overall survival. Results No grade 3 or 4 adverse events were recorded, and there was no difference in grade 1 or 2 adverse events between the two groups. Objective response rate and disease control rate for PVBTT were 58.9 and 91.2%, respectively, in the combined treatment group, which were significantly greater than the 5.7 and 54.3% rates, respectively, in the TACE-alone group (both p’s ≤ 0.001). Intrahepatic tumor response was positively correlated with the PVBTT response (γ = 0.782, p p p = 0.003). Multivariate analysis revealed that application of brachytherapy and lower grade PVBTT (Vp1 + Vp2 vs. Vp3) were protective predictors of overall survival. In stratified analysis, the benefit of overall survival was more significant in the subgroup of PVBTT Vp1 + Vp2 rather than in Vp3. Conclusions The combination of iodine-125 seed brachytherapy guided by ultrasound and TACE is a convenient, safe, and effective treatment for patients with HCC and PVBTT, conferring a better survival benefit than TACE alone.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6391bc1722ca3c2784a02ce8cf92fb10 https://doaj.org/article/4a87acfb8d334fab8b97cb5de3b18853 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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