Endovascular brachytherapy combined with stent placement and TACE for treatment of HCC with main portal vein tumor thrombus.
METHODS
To evaluate the safety and efficacy of endovascular brachytherapy (EVBT) with iodine-125 ((125)I) seed strand implantation combined with stent placement and transarterial chemoembolization (TACE) to treat hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (MPVTT).


METHODS
Data of 276 consecutive HCC patients with MPVTT treated by stent placement and TACE were analyzed retrospectively. (125)I seed strands were implanted in 182 patients (group A). The remaining 94 patients, who did not receive EVBT, served as control (group B). The overall survival, free of disease progression survival, stent patency period and procedure-related complications were compared between the two groups.


RESULTS
During a mean 9.9 ± 9.7 month (range 1.3-62.2 months) follow-up, the median survival time was 9.3 ± 0.9 months (95 % CI 7.6-11.0 months) in group A compared to 4.9 ± 0.5 months (95 % CI 4.0-5.8 months) in group B (p < 0.001). Median free of disease progression survival time in group A and B was 1.8 ± 0.1 months (95 % CI 1.6-2.0 months) and 1.5 ± 0.1 months (95 % CI 1.3-1.7 months), respectively (p < 0.001). Median stent patency period was 9.2 ± 1.1 months (95 % CI 7.0-11.4 months) in group A and 4.8 ± 0.5 months (95 % CI 3.9-5.7 months) in group B, respectively (p < 0.001).


CONCLUSIONS
These findings suggested that EVBT combined with stent placement and TACE might be a safe and effective palliative treatment option for HCC with main portal vein tumor thrombus.
Department of Interventional Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, 200032, Shanghai, China.
Jian-Jun
JJ
Luo
Department of Interventional Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, 200032, Shanghai, China.
Zi-Han
ZH
Zhang
Department of Interventional Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, 200032, Shanghai, China.
Qing-Xin
QX
Liu
Department of Interventional Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, 200032, Shanghai, China.
Wen
W
Zhang
Department of Interventional Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, 200032, Shanghai, China.
Jian-Hua
JH
Wang
Department of Interventional Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, 200032, Shanghai, China. yan.zhiping@hotmail.com.
Zhi-Ping
ZP
Yan
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*
D007457:Iodine Radioisotopes
Endovascular brachytherapy; Hepatocellular carcinoma; Main portal vein; Stent placement; Transarterial cheoembolization; Tumor thrombus