Transarterial chemoembolization plus iodine-125 implantation for hepatocellular carcinoma: a systematic review and meta-analysis

Zhu, Zexin; Wang, Xiaoxue; Yuan, Kefei; Huang, Jiwei; Zeng, Yong

doi:10.1016/j.hpb.2018.03.015

Cited by 19 publications

(15 citation statements)

References 36 publications

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“…Previous studies reported that TACE conferred significant survival benefits or reduced tumor growth in patients with HCC, 21,22 with a notable effect on 2-year survival. 23 A meta-analysis 24 of nine studies reported significantly higher 1-year OS (odds ratio [OR]: 4.72, 95%CI: 2.63, 8.47, P < 0.001) and 2-year OS (OR: 4.72, 95%CI: 2.63, 8.47, P < 0.001) in patients treated with TACE–iodine-125 compared with TACE alone. The results of the current study similarly showed that patients with HCC (≤5 cm) treated with TACE–iodine-125 particle implantation had longer median PFS (16 months vs 8 months, P < 0.001) and OS (42 months vs 23 months, P = 0.005) than those treated with TACE alone.…”

Section: Discussionmentioning

confidence: 99%

Transarterial chemoembolization combined with iodine-125 seed implantation for patients with hepatocellular carcinoma: a retrospective controlled study

et al. 2020

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Objective To determine if iodine-125 seed implantation improved the efficacy of transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) (≤5 cm). Methods We retrospectively reviewed the medical records of 83 consecutive patients with HCC (≤5 cm) who underwent TACE or TACE–iodine-125 from January 2014 to July 2017. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall survival (OS) and objective response rate (ORR) at 3 months after the first TACE treatment. PFS and OS were calculated using the Kaplan–Meier method and compared using log-rank tests. Independent risk factors for PFS and OS were analyzed using a Cox proportional hazards model. Results Thirty-five patients received TACE–iodine-125 and 48 received TACE alone. The median OS and PFS were both significantly longer in the TACE–iodine-125 compared with the TACE-alone group (42 vs 23 months and 16 vs 8 months, respectively). The ORR was significantly higher in the TACE–iodine-125 compared with the TACE-alone group. There was no significant difference in adverse events, apart from decreased white cell count, between the two groups. Conclusion TACE–iodine-125 might be an effective and safe alternative treatment for patients with HCC (≤5 cm).

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Section: Discussionmentioning

confidence: 99%

Transarterial chemoembolization combined with iodine-125 seed implantation for patients with hepatocellular carcinoma: a retrospective controlled study

et al. 2020

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“…ISI implantation has been gradually developed in clinical practice as a new, minimally invasive treatment for unresectable HCC therapy. Previous studies have shown that TACE combined with ISI permit to control liver tumors by local therapy, which is beneficial for patients [ 11 , 12 ]. Basic experimental studies have confirmed that 125 I seed implantation control tumors mainly through apoptosis and G2/M cell cycle arrest [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Iodine-125 ( 125 I) seed implantation (ISI) is being increasingly used as a minimally invasive treatment and in the treatment of intrahepatic and extrahepatic tumors, as it has been shown to achieve a better effect [ 9 , 10 ]. Combined TACE treatment for HCC can result in prolonged survival [ 11 , 12 ]. To our knowledge, the ISI after TACE treatment of local residual HCC or CCC tumors in challenging locations has limited coverage in the literature.…”

Section: Purposementioning

confidence: 99%

Iodine-125 seed implantation for residual hepatocellular carcinoma or cholangiocellular carcinoma in challenging locations after transcatheter arterial chemoembolization. Initial experience and findings

Zhang

Sun

et al. 2020

jcb

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Purpose To evaluate the clinical efficacy and safety of computed tomography (CT)-guided iodine-125 ( 125 I) seed implantation (ISI) for hepatocellular carcinoma (HCC) or cholangiocellular carcinoma (CCC) lesions in challenging locations after transcatheter arterial chemoembolization (TACE). Material and methods A retrospective single-center review of 24 patients with HCC or CCC tumors in challenging locations (hepatic dome or close to the heart/diaphragm/hepatic hilum) was conducted. Patients who underwent CT-guided 125 I implantation from May 2014 to January 2019 were recruited. Patients’ demographics and details including technical success, treatment response, patient survival, and complication rate were also evaluated. Results Treated tumors were located in the hepatic dome ( n = 10; 41.7%), subcapsularly ( n = 6; 25%), close to the heart ( n = 3; 12.5%), and in the liver hilum ( n = 5; 20.8%). The mean maximum diameter of tumors in challenging locations was 40.08 ±11.34 mm (range, 25-68 mm). TACE (2 ±1, 1-4 times) was applied before ISI. There were 27 ISI treatments administered (3 patients also received supplemental ISI). The total number of implanted seeds was 1,160, with mean 48 ±16 seed per patient (range, 30-90 seeds). The mean D 90 value for ISI was 125 Gy. Technical success rate was 100%, while a complete response + partial response (CR + PR) was documented in 70.83%, 79.17%, 83.33%, and 79.17% of patients at 3, 6, 12, and 24 months post-ISI, respectively. There were no major complications, although 2 cases experienced 125 I seed transfer to the diaphragm, and 1 case experienced transfer to the heart cavity. Conclusions CT-guided ISI for HCC or CCC lesions in challenging locations after TACE is both highly effective and safe.

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“…Typically, in the treatment of HCC, the implantation of iodine 125 seeds is combined with other treatment modalities, such as RFA or surgery [16,17]. It has been demonstrated that the combined treatment of TACE with iodine 125 seeds implantation (TACE-Iodine 125) provides a longer survival time than TACE alone for patients with HCC at different stages [18,19]. However, the efficacy of TACE-Iodine 125 in early-and intermediate-stage HCC is still unclear.…”

Section: Introductionmentioning

confidence: 99%

Transarterial chemoembolization combined with iodine 125 seeds versus transarterial chemoembolization combined with radiofrequency ablation in the treatment of early- and intermediate-stage hepatocellular carcinoma

et al. 2020

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Background: Transarterial chemoembolization (TACE), radiofrequency ablation (RFA), and iodine 125 seeds implantation are optional treatments for hepatocellular carcinoma (HCC). The aim of this study is to compare the efficacy of the combined treatment of TACE with iodine 125 seeds implantation (TACE-iodine 125) with TACE with RFA (TACE-RFA) in patients with early-and intermediate-stage HCC. Methods: The study included 112 patients who were diagnosed with early-and intermediate-stage HCC from January 1, 2014, to May 31, 2018. Among them, 38 patients were treated with TACE-Iodine 125, and 74 with TACE-RFA. The efficacy of the two treatment groups was retrospectively analyzed. To reduced the selective bias, a propensity score matching (PSM) analysis and inverse probability of treatment weighting (IPTW) method were used to compare the outcomes between the two groups.

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Transarterial chemoembolization plus iodine-125 implantation for hepatocellular carcinoma: a systematic review and meta-analysis

Abstract: Based on these findings, TACE plus iodine-125 implantation achieves better clinical efficacy compared with TACE alone in the treatment of HCC.

Cited by 19 publications

References 36 publications

Transarterial chemoembolization combined with iodine-125 seed implantation for patients with hepatocellular carcinoma: a retrospective controlled study

Transarterial chemoembolization combined with iodine-125 seed implantation for patients with hepatocellular carcinoma: a retrospective controlled study

Iodine-125 seed implantation for residual hepatocellular carcinoma or cholangiocellular carcinoma in challenging locations after transcatheter arterial chemoembolization. Initial experience and findings

Transarterial chemoembolization combined with iodine 125 seeds versus transarterial chemoembolization combined with radiofrequency ablation in the treatment of early- and intermediate-stage hepatocellular carcinoma

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