Clinical efficacy of CT-guided 125I brachytherapy in patients with local residual or recurrent hepatocellular carcinoma after thermal ablation

Insights into Imaging

Original Article

Huzheng Yan¹  Fujun Zhang²  Zhihui Zhong²  Wenliang Zhu²  Meigui Xiao²  Huanqing Guo²  Fei Gao²  Xu He³ 

[1] Department of Interventional Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, No. 600, Tianhe Road, Tianhe District, 510630, Guangzhou, People’s Republic of China;Department of Minimally Invasive and Interventional Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road, East, 510060, Guangzhou, People’s Republic of China;ZhuHai Interventional Medical Center, ZhuHai People’s Hospital (ZhuHai Hospital Affiliated With Jinan University), Jinan University, 519000, ZhuHai, Guangdong, People’s Republic of China;

关键词: I brachytherapy;    Hepatocellular carcinoma;    Local residual or recurrent;    Thermal ablation;   

DOI  :  10.1186/s13244-022-01327-z

 received in 2022-08-11, accepted in 2022-11-09,  发布年份 2022

来源: Springer

【 摘 要 】

ObjectivesTreatment methods of local residual or recurrent hepatocellular carcinoma (HCC) after thermal ablation are limited. Therefore, our study aimed to explore the efficacy and prognostic factors of 125I brachytherapy for local residual or recurrent lesion after thermal ablation.MethodsA total of 114 patients with 212 local residual or recurrent HCC tumors after thermal ablation underwent 125I brachytherapy. Local progression-free survival (LPFS) and prognostic factors were analyzed by Kaplan–Meier curves and the Cox model.ResultsAfter a 6-month follow-up, the percentage of patients who achieved complete response (CR), partial response (PR), and stable disease (SD) was 57%, 13.2%, and 5.2%, respectively. The 1-, 2-, and 3-year LPFS rates were 58.7%, 50.0%, and 41.2%, respectively. Portal vein tumor thrombus (PVTT) (p = 0.03), the number of intrahepatic tumors (p = 0.01), and AFP level (p = 0.02) were independent risk factors for local tumor progression (LTP). The median LPFS in patients without PVTT (22 months) was much longer compared to those with PVTT (10 months). The median LPFS in patients with less than three intrahepatic lesions improved from 17 to 24 months. The median LPFS was only 5 months in the high AFP group, but was prolonged with a decrease in AFP level (24 months). No severe complications were recorded. All complications were controllable and treatable.ConclusionsCT-guided 125I brachytherapy was a safe and effective treatment for patients with local residual or recurrent HCC after thermal ablation to improve local control rate.

【 授权许可】

CC BY   
© The Author(s) 2022

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