Adjuvant Iodine<sup><b>131</b></sup>Lipiodol after Resection of Hepatocellular Carcinoma

Furtado, Ruelan; Ha, Leo; Clarke, Stephen; Sandroussi, Charbel

doi:10.1155/2015/746917

Cited by 7 publications

(5 citation statements)

References 24 publications

(21 reference statements)

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“…The IRT included I 131 -mAb, I 131 -lipiodol and I 125 seeds, obviously three strong RCTs provided the benefits for all the internal radiotherapy(Chen et al 2013 ; Lau et al 1999 ; Li et al 2020a ). However, some studies didn’t show any recurrence-free or OS benefit(Chung et al 2013 ; Furtado et al 2015 ).The implantation of internal radioactive source is also technique requirement which might be restriction of the application. The ranking of different treatments according to SUCRA was as follows: TACE + PVC, 88.0%; IRT, 82.3%; ERT, 72.8%; AIT, 71.8%; Huaier, 59.4%; HAIC, 58.7%; TACE, 51.0%, IFN, 48.0%; OCT, 39.0%; CIK, 36.7%; DC, 30.7%; BCAA, 30.5%; NA, 23.4%; SOR, 7.8%.…”

Section: Discussionmentioning

confidence: 99%

Network meta-analysis of adjuvant treatments for patients with hepatocellular carcinoma after curative resection

Ye,

Wang,

et al. 2023

BMC Gastroenterol

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Purpose The prevention of recurrence for patients with hepatocellular carcinoma after curative resection is still a great challenge in clinical practice. There are numerous studies that trying to search for favorable strategies to decrease the recurrence and prolong life span for these patients, whereas no consensus is reached till now. Herein, we aim to compare the efficacy between different reported treatments by network meta-analysis(NMA). Methods We searched Pubmed, Web of Science and Cochrane Library for abstracts and full-text articles published from database inception through February 2023. All of the random controlled trials(RCTs) were evaluated and collected as eligible studies. The primary outcome was the prevention of recurrence between different procedures. The second outcomes were one-year survival, three-year survival and five-year survival. Results Thirty-two RCTs including 5783 patients were selected, and 12 treatments were classified. Most of the studies were high quality with low bias. Thirty-one studies including 5629 patients were recruited for recurrence analysis. The network meta-analysis showed benefits from transarterial chemoembolization(TACE) + portal vein chemotherapy(PVC)[OR, 2.84 (1.15,6.99)] and internal radiotherapy(IRT) [OR, 2.63 (1.41,4.91)] compared to non-adjuvant(NA) treatment when considering prevention of recurrence. Seventeen studies including 2047 patients were collected for one-year survival analysis. The network meta-analysis showed benefit from TACE[OR, 0.33 (0.14,0.75)] when considering one-year survival. Twenty-one studies including 2463 patients were collected for three-year survival analysis. The network meta-analysis showed TACE [OR, 0.51 (0.30,0.86)], IRT[OR, 0.41 (0.20,0.83)] and dendritic cell(DC) [OR, 0.09 (0.01,0.98)] were better than NA when considering three-year survival. Sixteen studies including 1915 patients were collected for five-year survival analysis. The network meta-analysis didn’t show any benefit from different treatments when considering five-year survival. Other strategies including external radiotherapy(ERT), branched-chain amino acids(BCAA), hepatic artery infusion chemotherapy(HAIC), cytokine-induced killer(CIK), adoptive immunotherapy(AIT), Huaier, interferon(IFN), oral chemotherapy(OCT) and sorafenib(SOR) didn’t show significant benefit regardless of prevention of recurrence or short-, long- time survival. Conclusion This NMA found that TACE + PVC and IRT were considered as the procedures to decrease HCC recurrence rate. TACE, IRT and DC were preferred when considering the extending of life span for post-operative patients with HCC. Large scale of RCTs are needed to verify it.

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Section: Discussionmentioning

confidence: 99%

Network meta-analysis of adjuvant treatments for patients with hepatocellular carcinoma after curative resection

Ye,

Wang,

et al. 2023

BMC Gastroenterol

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“…However, a multicenter RCT involving 103 patients showed that the adjuvant 131I-iodine oil treatment did not improve RFS and OS[ 55 ]. Another retrospective study with the largest sample to date showed no significant survival improvement with the 131I-iodine oil adjuvant therapy[ 56 ]. The results of the meta-analysis showed that intra-arterial instillation of 131I-iodine oil after hepatectomy significantly reduced the risk of HCC recurrence and improved DFS and OS[ 57 , 58 ], but it still needs to be confirmed by multicenter large sample RCTs.…”

Section: Adjunctive Local Treatmentmentioning

confidence: 99%

Advances in postoperative adjuvant therapy for primary liver cancer

Zeng¹,

Mo²,

Zeng³

et al. 2022

WJGO

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Hepatocellular carcinoma (HCC) is a highly heterogeneous, invasive, and conventional chemotherapy-insensitive tumor with unique biological characteristics. The main methods for the radical treatment of HCC are surgical resection or liver transplantation. However, recurrence rates are as high as 50% and 70% at 3 and 5 years after liver resection, respectively, and even in Milan-eligible recipients, the recurrence rate is approximately 20% at 5 years after liver transplantation. Therefore, reducing the postoperative recurrence rate is key to improving the overall outcome of liver cancer. This review discusses the risk factors for recurrence in patients with HCC radical surgical resection and adjuvant treatment options that may reduce the risk of recurrence and improve overall survival, including local adjuvant therapy ( e.g. , transcatheter arterial chemoembolization), adjuvant systemic therapy ( e.g. , molecular targeted agents and immunotherapy), and other adjuvant therapies ( e.g. , antiviral and herbal therapy). Finally, potential research directions that may change the paradigm of adjuvant therapy for HCC are analyzed.

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“… 38 Finally, another promising method seems to be the use of radiolabeled lipiodol, which is a safe radiotracer that leads to tumor necrosis and is associated with Disease-Free Survival (DFS) and OS benefit. 41 Despite the multiple clinical trials of TKIs and ICIs, that are underway, no systematic therapy is considered standard of care in the adjuvant setting.…”

Section: Postoperative Therapymentioning

confidence: 99%

Hepatocellular Carcinoma: An Overview of the Changing Landscape of Treatment Options

Koulouris

Tsagkaris

Spyrou

et al. 2021

JHC

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The last three years have seen remarkable progress in comprehending predisposing factors and upgrading our treatment arsenal concerning hepatocellular carcinoma (HCC). Until recently, there were no means to withstand the progression of viral hepatitis-associated liver cirrhosis to HCC. A deeper understanding of the molecular mechanism of the disease, the use of biomarkers, and the follow-up, allowed us to realize that conventional chemotherapy failing to increase survival in patients with advanced HCC tends to be exiled from clinical practice. Multi-kinase inhibitors (TKIs) such as sorafenib, lenvatinib targeting mainly the vascular endothelial growth factor receptors 1-3 VEGFRs 1-3 provided until recently the standard of care for these patients, as first-or second-line treatment. Since May 2020, the atezolizumab plus bevacizumab combination (immunotherapy plus anti-VEGF) has become the new reference standard in first-line HCC treatment. Additionally, anti-programmed cell death protein 1 (anti-PD-1) immunotherapy can be used as a secondline treatment following first-line treatment's failure. Phase III clinical trials have recently suggested the efficacy of novel anti-angiogenic factors such as cabozantinib and ramucirumab as a second-line treatment option. With considerations about toxicity arising, clinical trials are investigating combinations of the aforementioned targeted therapies with immunotherapy as first-line treatment. This paper aims to perform a systematic review describing the evolving treatment options for HCC over the last decades, ranging from neoadjuvant treatment to systemic therapy of advanced-stage HCC. With the landscape of HCC treatment shifting towards novel agents the forming of a new therapeutic algorithm for HCC seems to be imperative.

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Adjuvant Iodine¹³¹Lipiodol after Resection of Hepatocellular Carcinoma

Cited by 7 publications

References 24 publications

Network meta-analysis of adjuvant treatments for patients with hepatocellular carcinoma after curative resection

Network meta-analysis of adjuvant treatments for patients with hepatocellular carcinoma after curative resection

Advances in postoperative adjuvant therapy for primary liver cancer

Hepatocellular Carcinoma: An Overview of the Changing Landscape of Treatment Options

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Adjuvant Iodine131Lipiodol after Resection of Hepatocellular Carcinoma

Cited by 7 publications

References 24 publications

Network meta-analysis of adjuvant treatments for patients with hepatocellular carcinoma after curative resection

Network meta-analysis of adjuvant treatments for patients with hepatocellular carcinoma after curative resection

Advances in postoperative adjuvant therapy for primary liver cancer

Hepatocellular Carcinoma: An Overview of the Changing Landscape of Treatment Options

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Adjuvant Iodine¹³¹Lipiodol after Resection of Hepatocellular Carcinoma