title: Adjuvant iodine-125 brachytherapy for hepatocellular carcinoma after complete hepatectomy: a randomized controlled trial.
abstract: BACKGROUND
  Tumor recurrence is a major problem after curative resection of hepatocellular carcinoma (HCC). The current study evaluated the effects of adjuvant iodine-125 ((125)I) brachytherapy on postoperative recurrence of HCC.
  
  
  RESULTS
  From July 2000 to June 2004, 68 HCC patients undergoing curative hepatectomy were randomly assigned into a (125)I adjuvant brachytherapy group (n = 34) and a group of best care (n = 34). Patients in the (125)I adjuvant brachytherapy group received (125)I seed implantation on the raw surface of resection. Patients in the best care control group received identical treatments except for the (125)I seed implantation. Time to recurrence (TTR) and 1-, 3- and 5-year overall survival (OS) were compared between the two groups. The follow-up ended in January 2010, and lasted for 7.7-106.4 months with a median of 47.6 months. TTR was significantly longer in the (125)I group (mean of 60.0 months vs. 36.7 months in the control). The 1-, 3- and 5-year recurrence-free rates of the (125)I group were 94.12%, 76.42%, and 73.65% vs. 88.24%, 50.00%, and 29.41% compared with the control group, respectively. The 1-, 3- and 5-year OS rates of the (125)I group were 94.12%, 73.53%, and 55.88% vs. 88.24%, 52.94%, and 29.41% compared with the control group, respectively. The (125)I brachytherapy decreased the risk of recurrence (HR = 0.310) and the risk of death (HR = 0.364). Most frequent adverse events in the (125)I group included nausea, vomiting, arrhythmia, decreased white blood cell and/or platelet counts, and were generally mild and manageable.
  
  
  CONCLUSIONS
  Adjuvant (125)I brachytherapy significantly prolonged TTR and increased the OS rate after curative resection of HCC.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12610000081011.
authors.affiliation: Department of General Surgery, the Second Provincial People's Hospital of Guangdong Province, Guangzhou, P. R. China.
authors.forename: Kaiyun
authors.initials: K
authors.lastname: Chen
authors.forename: Yong
authors.initials: Y
authors.lastname: Xia
authors.forename: Hanning
authors.initials: H
authors.lastname: Wang
authors.forename: Fanglian
authors.initials: F
authors.lastname: Xiao
authors.forename: Guoan
authors.initials: G
authors.lastname: Xiang
authors.forename: Feng
authors.initials: F
authors.lastname: Shen
mesh_terms: D000328:Adult; D001918:Brachytherapy; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016019:Survival Analysis
chemical_list: D007457:Iodine Radioisotopes