Jie Li1, Lijuan Zhang2, Qigen Xie3, Weiguo Wang3, Yanyan Hua3, Leyuan Zhou4, Zongqiong Sun5. 1. Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Jiangsu Province, Wuxi, China. Electronic address: lj1982020@126.com. 2. Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, Wuxi, China. 3. Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Jiangsu Province, Wuxi, China. 4. Department of Radiotherapy, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Jiangsu Province, Wuxi, China. 5. Department of Radiology, The Affiliated Hospital of Jiangnan University, Wuxi 4th People's Hospital, Jiangsu Province, Wuxi, China.
Abstract
PURPOSE: The effect of 125I seed implantation for the treatment of local residual tumor of hepatocellular carcinoma located beneath the diaphragm (HCC-LBD) after transcatheter arterial chemoembolization (TACE) has not yet been reported. This retrospective study was performed to evaluate the safety and efficacy of 125I seeds implantation (ISI) for the treatment of residual HCC-LBD after TACE. METHODS AND MATERIALS: A total of 18 patients treated with ISI between August 2012 and March 2018 for residual HCC-LBD after single or multiple TACE were enrolled. Local control, survival, and postoperative complications were analyzed retrospectively. Overall followup time was displayed by survival curves. RESULTS: The 18 patients received a total of 20 ISI treatments. The total number of seeds implanted was 650, with a mean of 36 ± 13 seeds per patients (range, 20-70). Mean D90 was 123 Gy. Complete response + partial response (CR + PR) was documented in 14, 16, and 16 of patients at 3, 6, and 12 months after implantation, respectively. In four patients, seeds implantation was performed through the diaphragm; two of these patients developed small pneumothoraces. Pulmonary compression of pneumothorax is less than 30% combined with a little blood in sputum, no chest tightness, shortness of breath, all symptoms subsided without interventions, and the patients were discharged after observation for 2 days. After the procedure, routine blood examination and liver and kidney function were normal. CONCLUSION: The combination of TACE with ISI appears to be a safe and efficient treatment for residual HCC-BLD. IMPLICATIONS FOR PRACTICE: This study evaluated the feasibility, safety, and short-term efficacy of ISI for local residual tumor of hepatocellular carcinoma located beneath the diaphragm (HCC-LBD) after TACE. Results suggest that residual tumor of HCC after TACE located in the posterosuperior part of the liver (segments seven and eight), laparoscopic liver resection, and alblation is difficult to perform and that as a supplement treatment, 125I seeds implantation is safe and easy accessible. TACE combined with 125I seeds has excellent local control effectiveness, and long-term efficacy and survival benefit still need to be more comprehensively evaluated.
PURPOSE: The effect of 125I seed implantation for the treatment of local residual tumor of hepatocellular carcinoma located beneath the diaphragm (HCC-LBD) after transcatheter arterial chemoembolization (TACE) has not yet been reported. This retrospective study was performed to evaluate the safety and efficacy of 125I seeds implantation (ISI) for the treatment of residual HCC-LBD after TACE. METHODS AND MATERIALS: A total of 18 patients treated with ISI between August 2012 and March 2018 for residual HCC-LBD after single or multiple TACE were enrolled. Local control, survival, and postoperative complications were analyzed retrospectively. Overall followup time was displayed by survival curves. RESULTS: The 18 patients received a total of 20 ISI treatments. The total number of seeds implanted was 650, with a mean of 36 ± 13 seeds per patients (range, 20-70). Mean D90 was 123 Gy. Complete response + partial response (CR + PR) was documented in 14, 16, and 16 of patients at 3, 6, and 12 months after implantation, respectively. In four patients, seeds implantation was performed through the diaphragm; two of these patients developed small pneumothoraces. Pulmonary compression of pneumothorax is less than 30% combined with a little blood in sputum, no chest tightness, shortness of breath, all symptoms subsided without interventions, and the patients were discharged after observation for 2 days. After the procedure, routine blood examination and liver and kidney function were normal. CONCLUSION: The combination of TACE with ISI appears to be a safe and efficient treatment for residual HCC-BLD. IMPLICATIONS FOR PRACTICE: This study evaluated the feasibility, safety, and short-term efficacy of ISI for local residual tumor of hepatocellular carcinoma located beneath the diaphragm (HCC-LBD) after TACE. Results suggest that residual tumor of HCC after TACE located in the posterosuperior part of the liver (segments seven and eight), laparoscopic liver resection, and alblation is difficult to perform and that as a supplement treatment, 125I seeds implantation is safe and easy accessible. TACE combined with 125I seeds has excellent local control effectiveness, and long-term efficacy and survival benefit still need to be more comprehensively evaluated.
Authors: Liangliang Yan; Lei Chen; Kun Qian; Xuefeng Kan; Hongsen Zhang; Bin Liang; Chuansheng Zheng Journal: Cancer Manag Res Date: 2021-05-13 Impact factor: 3.989