title: TACE Combined with Implantation of Irradiation Stent Versus TACE Combine with Bare Stent for HCC Complicated by IVCTT.
abstract: OBJECTIVE
  This study was designed to evaluate the safety and efficacy of transarterial chemoembolization (TACE) combined with intra-IVC implantation of an irradiation stent for the treatment of hepatocellular carcinoma (HCC) complicated by inferior vena cava tumor thrombosis (IVCTT).
  
  
  METHODS
  Sixty-one consecutive patients with HCC complicated by IVCTT treated by TACE combined with IVC stenting were retrospectively analysed. IVC stenting was performed using a stent loaded with (125)I seeds strands (the irradiation stent) in 33 patients (Group A) and 28 patients with a bare stent (Group B). Propensity score matching eliminated the baseline differences. Overall survival, oedema related to IVC obstruction remission rate and procedure-related adverse events were compared between the two groups.
  
  
  RESULTS
  The adverse effect rate was similar for both Group A and Group B patients, and complications were adequately handled by medical treatment. TACE combined with implantation of an irradiation stent showed a significant median survival benefit over TACE combined with a bare stent, with a median survival time of 203.0 ± 28.135 days versus 93.0 ± 24.341 days (p = 0.006). The propensity score-matched (24 pairs) cohort analyses (200 ± 31.231 days vs. 66 ± 23.270 days, p = 0.019). The oedema remission rate was 97.0 % in group A patients and 96.4 % in group B, respectively. TACE-irradiation stent and object tumor response were the independent prognostic factors of favorable survival.
  
  
  CONCLUSIONS
  TACE combined with irradiation stent implantation is a safe and effective treatment modality for patients with HCC complicated by IVCTT and may extend their survival time.
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.|Shanghai Institution of Medical Imaging, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
authors.forename: Qing-Hui
authors.initials: QH
authors.lastname: Yang
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.|Shanghai Institution of Medical Imaging, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.|Shanghai Institution of Medical Imaging, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
authors.forename: Qing-Xin
authors.initials: QX
authors.lastname: Liu
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.|Shanghai Institution of Medical Imaging, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
authors.forename: Ling-Xiao
authors.initials: LX
authors.lastname: Liu
authors.affiliation: Department of Oncology, Tengzhou Central People's Hospital, Tengzhou, China.
authors.forename: Lin-Lin
authors.initials: LL
authors.lastname: Wu
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.|Shanghai Institution of Medical Imaging, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. 798373254@qq.com.|Shanghai Institution of Medical Imaging, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. 798373254@qq.com.
authors.forename: Zhi-Ping
authors.initials: ZP
authors.lastname: Yan
authors.affiliation: Department of Interventional Radiology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. 12211210022@fudan.edu.cn.|Shanghai Institution of Medical Imaging, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. 12211210022@fudan.edu.cn.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Luo
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery*; D020246:Venous Thrombosis / Q000150:complications*
keywords: Brachytherapy; Hepatocellular carcinoma; Inferior vena cava; Iodine-125; Transarterial chemoembolization