PROPOSE: To evaluate the safety and efficacy of endovascular brachytherapy (EVBT) with iodine-125 ((125)I) seed strand implantation combined with stent placement and transarterial chemoembolization (TACE) to treat hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (MPVTT). METHODS: Data of 276 consecutive HCC patients with MPVTT treated by stent placement and TACE were analyzed retrospectively. (125)I seed strands were implanted in 182 patients (group A). The remaining 94 patients, who did not receive EVBT, served as control (group B). The overall survival, free of disease progression survival, stent patency period and procedure-related complications were compared between the two groups. RESULTS: During a mean 9.9 ± 9.7 month (range 1.3-62.2 months) follow-up, the median survival time was 9.3 ± 0.9 months (95 % CI 7.6-11.0 months) in group A compared to 4.9 ± 0.5 months (95 % CI 4.0-5.8 months) in group B (p < 0.001). Median free of disease progression survival time in group A and B was 1.8 ± 0.1 months (95 % CI 1.6-2.0 months) and 1.5 ± 0.1 months (95 % CI 1.3-1.7 months), respectively (p < 0.001). Median stent patency period was 9.2 ± 1.1 months (95 % CI 7.0-11.4 months) in group A and 4.8 ± 0.5 months (95 % CI 3.9-5.7 months) in group B, respectively (p < 0.001). CONCLUSION: These findings suggested that EVBT combined with stent placement and TACE might be a safe and effective palliative treatment option for HCC with main portal vein tumor thrombus.
PROPOSE: To evaluate the safety and efficacy of endovascular brachytherapy (EVBT) with iodine-125 ((125)I) seed strand implantation combined with stent placement and transarterial chemoembolization (TACE) to treat hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (MPVTT). METHODS: Data of 276 consecutive HCC patients with MPVTT treated by stent placement and TACE were analyzed retrospectively. (125)I seed strands were implanted in 182 patients (group A). The remaining 94 patients, who did not receive EVBT, served as control (group B). The overall survival, free of disease progression survival, stent patency period and procedure-related complications were compared between the two groups. RESULTS: During a mean 9.9 ± 9.7 month (range 1.3-62.2 months) follow-up, the median survival time was 9.3 ± 0.9 months (95 % CI 7.6-11.0 months) in group A compared to 4.9 ± 0.5 months (95 % CI 4.0-5.8 months) in group B (p < 0.001). Median free of disease progression survival time in group A and B was 1.8 ± 0.1 months (95 % CI 1.6-2.0 months) and 1.5 ± 0.1 months (95 % CI 1.3-1.7 months), respectively (p < 0.001). Median stent patency period was 9.2 ± 1.1 months (95 % CI 7.0-11.4 months) in group A and 4.8 ± 0.5 months (95 % CI 3.9-5.7 months) in group B, respectively (p < 0.001). CONCLUSION: These findings suggested that EVBT combined with stent placement and TACE might be a safe and effective palliative treatment option for HCC with main portal vein tumor thrombus.
Authors: Soung Won Jeong; Jae Young Jang; Kwang Yeun Shim; Sae Hwan Lee; Sang Gyune Kim; Sang-Woo Cha; Young Seok Kim; Young Deok Cho; Hong Soo Kim; Boo Sung Kim; Kyoung Ha Kim; Jung Hoon Kim Journal: Gut Liver Date: 2013-08-14 Impact factor: 4.519