eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
Current Issue Archive Supplements Articles in Press Journal Information Aims and Scope Editorial Office Editorial Board Register as Author Register as Reviewer Instructions for Authors Abstracting and indexing Subscription Advertising Information Links
SCImago Journal & Country Rank

6/2021
vol. 13
 
Share:
Share:
more
 
 
abstract:
Original paper

A combination of portal vein stent insertion and endovascular iodine-125 seed-strip implantation, followed by transcatheter arterial chemoembolization with sorafenib for treatment of hepatocellular carcinoma-associated portal vein tumor thrombus

Shuangxi Li
1
,
Baohua Li
1
,
Lei Li
1
,
Fangyu Xu
1
,
Xujun Yang
1
,
Wenhui Wang
1

1.
Interventional Department, The First Hospital of Lanzhou University, Lanzhou City, China
J Contemp Brachytherapy 2021; 13, 6: 670–679
Online publish date: 2021/12/30
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction
This study aimed to assess efficacy of portal vein stent (PVS) insertion and endovascular iodine-125 (125I) seed-strip implantation, followed by transcatheter arterial chemoembolization (TACE) with sorafenib (PVS-125I TACE-S) in patients with hepatocellular carcinoma (HCC)-associated type II or type III portal vein tumor thrombus (PVTT).

Material and methods
A retrospective study was performed on 53 consecutive patients with HCC and type II or type III PVTT, from May 2014 to July 2018. Patients were divided into 2 groups, including group A with 28 patients treated with PVS-125I TACE-S, and group B with 25 patients treated with TACE-S. Primary end-point was overall survival (OS), while secondary endpoints were hepatic function and disease control rate (DCR). Albumin-bilirubin (ALBI) score approach was used for evaluating liver function. Cox regression analysis was applied to identify factors associated with treatment outcomes.

Results
No pre-operative differences were found in ALBI scores between group A and group B (–2.57 ±0.42 vs. –2.61 ±0.38, p = 0.724), or in these scores at 1 month post-operatively (–2.62 ±0.46 vs. –2.20 ±0.59, p = 0.666). However, these scores were significantly different at 3 (–2.17 ±0.59 vs. –1.69 ±0.48, p = 0.007) and 6 (–2.28 ±1.23 vs. –1.47 ±0.31, p = 0.044) months post-operatively. In addition, group A exhibited higher DCR (71.4% vs. 44.0%, p = 0.043) after 6 months of treatment and extended OS duration (11.4 vs. 7.7 months, p = 0.007). A stratified analysis revealed that OS in patients with type II PVTT did not differ significantly (10.4 vs. 10.7 months, p = 0.689), but OS with type III varied significantly (11.5 vs. 7.5 months, p = 0.002). Multivariate analysis revealed that tumor size > 10 cm (p = 0.002) and multiple tumors (p = 0.022) were independent predictors for poor prognosis, whereas PVS-125I TACE-S was predictor for favorable patient’s prognosis (p = 0.040).

Conclusions
PVS-125I TACE-S represents a potentially viable strategy for improving hepatic functionality, DCR, and OS in HCC with type III PVTT compared with TACE-S alone.

keywords:

hepatocellular carcinoma, portal vein, iodine-125, transcatheter arterial chemoembolization, sorafenib

 
Quick links
© 2022 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.