CT guided 125iodine seed implantation for portal vein tumor thrombus in primary hepatocellular carcinoma.
BACKGROUND
This study evaluated the clinical application of CT guided 125iodine implantation in patients with portal vein tumor thrombus in primary hepatocellular carcinoma.


METHODS
The ten patients (9 males and 1 female, aged from 36 to 72 years) with portal vein tumor thrombus accompanying hepatocellular carcinoma had been treated with comprehensive therapy including surgery, transcatheter arterial chemoembolization, radiotherapy ablation, microwave ablation or percutaneous ethanol injection. The average diameter of each tumor thrombus was 21.5 mm x 30.5 mm. Seeds of 30 MBq 125I were implanted 5 mm apart within the portal vein tumor thrombus. The follow-up after 4 months included enhanced spiral CT.


RESULTS
CT screening of the tumours indicated that 4 out of 10 patients showed complete response to the therapy, 5 partial response and 1 stable disease. Adverse effects included aggravated abdominal dropsy and temporarily increased transaminase, which were controlled by medical management. Severe complications such as haemorrhage, biliary fistula, hepatic abscess, pancreatic fistula and hepatic function failure were not observed. Implanted seeds migrated to lung and left hepatic lobe in 1 case.


CONCLUSIONS
CT guided implantation of 125iodine seeds, can effectively treat portal vein tumor thrombus accompanying hepatocellular carcinoma with minimal damage and few complications.
Zhang
Fu-jun
FJ
State Key Laboratory of Oncology in South China, Department of Imaging and Interventional Radiology, Cancer Centre, Sun Yat-sen University, Guangzhou, Guangdong 510060, China. drzfj@263.net
Li
Chuan-xing
CX
Jiao
De-chao
DC
Zhang
Nian-hua
NH
Wu
Pei-hong
PH
Duan
Guang-feng
GF
Wu
Yue-xia
YX
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000150:complications / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011878:Radiotherapy / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology / Q000532:radiotherapy*
D007457:Iodine Radioisotopes