Transarterial chemoembolisation (TACE) combined with endovascular implantation of an iodine-125 seed strand for the treatment of hepatocellular carcinoma with portal vein tumour thrombosis versus TACE alone: a two-arm, randomised clinical trial

Yang, Mei; Fang, Zuxiang; Zhang, Yan; Luo, Jianjun; Liu, LingXiao; Zhang, Wen; Wu, Linlin; Ma, Jingqin; Yang, Qin; Liu, Qingxin

doi:10.1007/s00432-013-1568-0

Cited by 62 publications

(61 citation statements)

References 24 publications

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“…Endovascular implantation of 125 I seed strands was performed as previously described [15]. Conventional chemoembolization was performed using doxorubicin (Pfizer, New York, NY, USA) mixed with 5–20 mL of iodized oil (Lipiodol Ultra-Fluide, Laboratoire Guerbet, Villepinte, France).…”

Section: Methodsmentioning

confidence: 99%

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Portal Vein Stenting Combined with Iodine-125 Seeds Endovascular Implantation Followed by Transcatheter Arterial Chemoembolization for Treatment of Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus

Sun

Zhou

Zhu

et al. 2016

BioMed Research International

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Aim was to assess the therapeutic value of portal vein stenting (PVS) combined with iodine-125 seed (125I seed) strand endovascular implantation followed by transcatheter arterial chemoembolization (TACE) for treating patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT). This was a retrospective study of 34 patients aged 29–81 years, diagnosed HCC with PVTT, and treated with PVS combined with 125I seed strand endovascular implantation followed by TACE between January 2012 and August 2014. Survival, stent patency, technical success rate, complications related to the procedure, and adverse events were recorded. The technical success rate was 100%. No serious procedure-related adverse event was recorded. The median survival was 147 days. The cumulative survival rates and stent patency rates at 90, 180, and 360 days were 94.1%, 61.8%, and 32.4% and 97.1% (33/34), 76.9% (24/34), and 29.4% (10/34), respectively. PVS combined with 125I seed strand endovascular implantation followed by TACE is feasible for patients with HCC and PVTT. It resulted in appropriate survival and stent patency, with no procedure-related adverse effects.

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Section: Methodsmentioning

confidence: 99%

“…125 I seed implantation was attempted to treat HCC with PVTT and achieved excellent therapeutic efficacy [15] with a good safety profile [16]. The combination of radiation therapy and TACE has been explored before [17, 18].…”

Section: Introductionmentioning

confidence: 99%

Portal Vein Stenting Combined with Iodine-125 Seeds Endovascular Implantation Followed by Transcatheter Arterial Chemoembolization for Treatment of Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus

Sun

Zhou

Zhu

et al. 2016

BioMed Research International

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“…This combination therapy also improved the reperfusion rate of portal vein significantly [51]. Another study showed I 125 seeds followed by TACE significantly improved the median survival and progression free survival rates when compared to I 125 alone ( P = 0.037 and 0.002, respectively) [52].…”

Section: Nonsurgical Therapiesmentioning

confidence: 99%

Chinese expert consensus on multidisciplinary diagnosis and treatment of hepatocellular carcinoma with portal vein tumor thrombus: 2016 edition

2016

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Hepatocellular carcinoma is the fourth leading cause of cancer-related morbidity and mortality in China. Portal vein tumor thrombus (PVTT) is common and it worsens prognosis of hepatocellular carcinoma (HCC). There is no internationally accepted consensus or guideline for diagnosis and treatment of HCC with PVTT. Based on existing evidences and common current practices, Chinese Experts on Multidisciplinary Diagnosis and Treatment of HCC with portal vein tumor thrombus met to develop a national consensus on diagnosis and treatment of HCC with PVTT. The meeting concluded with the First Edition (version 2016) of consensus statements with grades of evidence given as grades Ia, Ib, IIa, IIb, III and IV, and ranking as Classes A, B, C, D and I for quality of evidence and strength of recommendation by the United State Preventive Service Task Force, respectively. The consensus suggests recommended treatment to be based on patients PVTT type and ECOG functional status; surgery being the preferred treatment for Child-Pugh A, PVTT type I/II, and ECOG PS 0-1; transcatheter arterial chemoembolization (TACE) for non-resectable PVTT I/II and Child-Pugh A; and radiotherapy for non-resectable PVTT I/II/III and Child-Pugh A. Symptomatic treatment is recommended for Child-Pugh C, with massive ascites or gastrointestinal bleeding. By updating clinicians with treatment options for HCC with PVTT, the consensus statement aimed to prolong overall survival and to improve quality of life of patients with minimal treatment complication. Future treatment strategies for HCC with PVTT in China would depend on new evidences from more future clinical trials, especially studies defining the role of traditional Chinese medicine and clarifying molecular aspects of HCC.

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“…[88] (evidence level 2); (2) TACE in combination with radiation therapy [84] (evidence level 2), which could be selectively used for patients with tumor emboli in the portal trunk and inferior vena cava or localized large HCC after TACE; (3) TACE in combination with surgical resection, which should be recommended for large HCCs that have shrunk after TACE and are suitable for surgical resection [88] (evidence level 3); and (4) TACE in combination with systemic treatment, including molecular target drugs, arsenic trioxide, radiolabeled drugs, gene therapy, immunotherapy, and systemic chemotherapy [93, 94]. …”

Section: Treatmentmentioning

confidence: 99%

“…(2) The tumor emboli in the portal vein trunk can be effectively treated to resume blood flow by portal vein stenting and I-125 seed strip or I-125 seed portal vein stenting [88] (evidence level 2).…”

Section: Treatmentmentioning

confidence: 99%

Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2017 Edition)

Zhou¹,

Sun²,

Wang³

et al. 2018

Liver Cancer

498

449

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Background: Hepatocellular carcinoma (HCC) (about 85–90% of primary liver cancer) is particularly prevalent in China because of the high prevalence of chronic hepatitis B infection. HCC is the fourth most common malignancy and the third leading cause of tumor-related deaths in China. It poses a significant threat to the life and health of Chinese people. Summary: This guideline presents official recommendations of the National Health and Family Planning Commission of the People’s Republic of China on the surveillance, diagnosis, staging, and treatment of HCC occurring in China. The guideline was written by more than 50 experts in the field of HCC in China (including liver surgeons, medical oncologists, hepatologists, interventional radiologists, and diagnostic radiologists) on the basis of recent evidence and expert opinions, balance of benefits and harms, cost-benefit strategies, and other clinical considerations. Key Messages: The guideline presents the Chinese staging system, and recommendations regarding patients with HCC in China to ensure optimum patient outcomes.

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Transarterial chemoembolisation (TACE) combined with endovascular implantation of an iodine-125 seed strand for the treatment of hepatocellular carcinoma with portal vein tumour thrombosis versus TACE alone: a two-arm, randomised clinical trial

Abstract: Transarterial chemoembolisation combined with the endovascular implantation of an iodine-125 seed strand is feasible, safe and effective in the treatment for hepatocellular carcinoma with PVTT.

Cited by 62 publications

References 24 publications

Portal Vein Stenting Combined with Iodine-125 Seeds Endovascular Implantation Followed by Transcatheter Arterial Chemoembolization for Treatment of Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus

Portal Vein Stenting Combined with Iodine-125 Seeds Endovascular Implantation Followed by Transcatheter Arterial Chemoembolization for Treatment of Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus

Chinese expert consensus on multidisciplinary diagnosis and treatment of hepatocellular carcinoma with portal vein tumor thrombus: 2016 edition

Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China (2017 Edition)

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