Predictive factors of benefit from iodine-125 brachytherapy for hepatocellular carcinoma with portal vein tumor thrombosis

Lin, Junqing; Jiang, Han; Weizhu, Yang; Jiang, Na; Zheng, Qi; Huang, Ning; Wang, Xiaolong; Li, Ang; Huang, Jinke

doi:10.1016/j.brachy.2018.10.002

Cited by 11 publications

(8 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TIPS can achieve these, in addition to improving the survival rate of patients. 125 I has a good therapeutic effect and can improve the survival rate of patients[17,18]. However, 125 I implantation documented in the literature was combined with percutaneous liver puncture or TACE in the form of particle strands, which had some disadvantages, such as limited number of particles being implanted.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, the application of 125 I in treating PVTT has shown a curative effect[18,22-24]. A retrospective matched cohort study[2] has suggested that TACE combined with 125 I seed implantation may be a good choice for selected hepatitis B HCC patients with PVTT.…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective matched cohort study[2] has suggested that TACE combined with 125 I seed implantation may be a good choice for selected hepatitis B HCC patients with PVTT. Lin et al[18] found the median OS in HCC patients with PVTT, treated with 125 I brachytherapy was 7 mo in the MPV group, which was lower than that in other groups, such as the right or left portal vein group and segmental branches of portal vein group. Luo et al[8] compared the therapeutic effect between the group treated with 125 I + TACE + stent implantation (group A) and the group treated with stent implantation + TACE (group B).…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Iodine-125 implantation with transjugular intrahepatic portosystemic shunt for main portal vein tumor thrombus

Zhang

Yue

et al. 2019

WJGO

View full text Add to dashboard Cite

BACKGROUND Main portal vein tumor thrombus (MPVTT), which has a high incidence, is the major complication of terminal liver cancer. The occurrence of MPVTT is always a negative prognostic factor for patients with hepatocellular carcinoma (HCC). Therefore, attention should be paid to the treatment of MPVTT and its complications. AIM To evaluate the efficacy of transarterial chemoembolization/transarterial embolization (TACE/TAE)+ 125 I seeds implantation with transjugular intrahepatic portosystemic shunt (TIPS) in treating MPVTT and its complications. METHODS From January 2007 to March 2015, 85 consecutive patients with MPVTT were nonrandomly assigned to undergo treatment with TACE/TAE + TIPS and 125 I implantation (TIPS- 125 I group) or TACE/TAE + TIPS only (TIPS only group) in Beijing Shijitan Hospital, and all clinical data were collected. During 24 mo follow-up, the incidence of overall survival, stent stenosis and symptom recurrence was analyzed to evaluate the efficacy of TIPS- 125 I. RESULTS During 24 mo follow-up of all patients, we collected data at 6, 12 and 24 mo. The rates of survival were 80%, 45%, and 20%, respectively, in the TIPS- 125 I group, whereas those in the TIPS only group were 64.4%, 24.4%, and 4.4%, respectively ( P < 0.05). The rates of symptom recurrence were 7.5%, 22.5%, and 35%, respectively, in the TIPS- 125 I group, whereas those in the TIPS only group were 31.1%, 62.2%, and 82.2% ( P < 0.05). The rates of stent restenosis were 12.5%, 27.5%, and 42.5%, respectively, in the TIPS- 125 I group, and 42.2%, 68.9%, and 84.4%, respectively, in the TIPS only group ( P < 0.05). TIPS- 125 I was found to be significantly favorable in treating MPVTT and its complications in patients with HCC. CONCLUSION TACE/TAE+ 125 I combined with TIPS is effective in treating MPVTT and its complications, improving quality of life of patients and reducing mortality.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Iodine-125 implantation with transjugular intrahepatic portosystemic shunt for main portal vein tumor thrombus

Zhang

Yue

et al. 2019

WJGO

View full text Add to dashboard Cite

show abstract

“…21,23 In a previous study, better overall response rate as well as a significantly favorable level of survival Du N. et al: A novel endovascular brachytherapy stent were observed in patients who received TACE combined with EVB with 125 I seeds strand and stent placement. [24][25][26] Numerous studies have demonstrated that stent devices that are combined with EVB exert therapeutic efficacy in PVTT, unresectable malignant esophageal and biliary obstruction. 21,27,28 The eccentric distribution of the 125 I seeds strand may cause the delivery of an insufficient radiation dose to the contralateral blood vessel wall, thus compromising the therapeutic efficacy.…”

Section: Discussionmentioning

confidence: 99%

Development of a Novel Endovascular Brachytherapy Stent: A Proof-of-concept Study

Du¹,

Ma²,

Zhang³

et al. 2021

Journal of Clinical and Translational Hepatology

View full text Add to dashboard Cite

Background and Aims: Endovascular implantation of iodine-125 ( 125 I) seeds strand combined with stent is an effective method of treatment for portal vein tumor thrombosis. The aim of this study was to develop a novel endovascular brachytherapy stent (EVB-Stent) and to evaluate its feasibility of use. Methods: An EVB-Stent was implanted into the main portal vein (MPV) in a live porcine model via the percutaneous transhepatic route. Blood samples were collected and tested before and after operation, as well as before euthanasia. Single-photon emission computed tomography (SPECT) combined with CT (SPECT/CT) scan were performed directly after operation and CT scan was performed 2 months after implantation. After the CT scan was performed, all animals were euthanized and histologically examined. Results: The novel stent was successfully positioned in all six pigs. No deterioration of liver function was observed during the 2-month follow-up period. SPECT/ CT revealed the uniform distribution of radiation around the seeds strand, and the hottest spot was near the center of the MPV. The patency of the stented MPV was confirmed using CT scans. The tissue-accumulated absorbed dose was 31,822.11 mGy at 10 mm transversely away from the midpoint of the 125 I seeds strand, with a half-life of 59.4 days. Pathological examination results showed no significant atrophy or inflammation of adjunct liver tissue, and no obvious intima thickening or thrombosis were detected in the stented MPV. Conclusions: A liver porcine model was used to demonstrate that the transhepatic placement of a novel endovascular brachytherapy stent, EVB-Stent, is both technically feasible and safe.

show abstract

“…While sorafenib combination treatment can reduce TACEassociated risks and improve outcomes, there are reports suggesting that sorafenib is less effective in those with Vp3/4 PVTT (< 10% response rate) [11,33]. In contrast, 125 I seed implantation in the portal vein can allow for effective PVTT control owing to sustained low-dose x-and γ-ray release throughout the tumor area, damaging tumor cell DNA and disrupting proliferation [24,34].…”

Section: Discussionmentioning

confidence: 99%

Treatment of Hepatocellular Carcinoma-associated Portal Vein Tumor Thrombus Using Combination of Portal Vein Stent Insertion and Endovascular Lodine-125 Seed-strip Implantation Followed by Transcatheter Arterial Chemoembolization- Sorafenib

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundTo evaluate the efficacy of portal vein stent (PVS) insertion and endovascular iodine-125 (125I) seed-strip implantation followed by transcatheter arterial chemoembolization (TACE)-sorafenib (PVS-125I-TACE-S) in patients with hepatocellular carcinoma (HCC)-associated portal vein tumor thrombus (PVTT).MethodsThis retrospective analysis was performed on 53 consecutive HCC patients with PVTT between May 2014 and July 2018. Twenty-eight patients were treated via PVS-125I-TACE-S, and 25 patients were treated by TACE-S. Hepatic function, disease control, and overall survival (OS) in both groups were analyzed. The Albumin-Bilirubin (ALBI) score approach was used as a means of evaluating liver function, and a Cox regression analysis was utilized to determine which factors were linked to treatment outcomes.ResultsNo preoperative differences in ALBI scores between groups (P=0.724), nor did these scores at 1-month postoperative (P=0.666). However, these scores were significantly different at 3 (P=0.007) and 6 (P=0.044) months postoperatively. PVS-125I-TACE-S exhibiting higher rates of disease control (71.4% vs. 44.0%, P=0.043) after 6 months of treatment and extended OS duration (342.0 vs 231.0 days, P=0.007). A stratified analysis revealed OS in patients with type II PVTT did not differ significantly (313.0 vs. 321.0 days, P=0.689), but OS with type III did (344.0 vs. 226.0 days, P=0.002). A multivariate analysis revealed that tumor size > 10 cm was independently predictive of poor prognosis (P=0.002), whereas PVS-125I-TACE-S was a predictor of a favorable patient prognosis (P=0.040).ConclusionPVS-125I-TACE-S represents a potentially viable strategy for improving hepatic functionality, disease control, and OS in HCC with type III PVTT.

show abstract

Predictive factors of benefit from iodine-125 brachytherapy for hepatocellular carcinoma with portal vein tumor thrombosis

Cited by 11 publications

References 32 publications

Iodine-125 implantation with transjugular intrahepatic portosystemic shunt for main portal vein tumor thrombus

Iodine-125 implantation with transjugular intrahepatic portosystemic shunt for main portal vein tumor thrombus

Development of a Novel Endovascular Brachytherapy Stent: A Proof-of-concept Study

Treatment of Hepatocellular Carcinoma-associated Portal Vein Tumor Thrombus Using Combination of Portal Vein Stent Insertion and Endovascular Lodine-125 Seed-strip Implantation Followed by Transcatheter Arterial Chemoembolization- Sorafenib

Contact Info

Product

Resources

About