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Safety and Feasibility of Helical I-125 Seed Implants Combined with Transcatheter Arterial Chemoembolization in Hepatocellular Carcinomas with Main Portal Vein Tumor Thrombus

  • Clinical Investigation
  • Interventional Oncology
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the feasibility and safety of a helical iodine-125 (I-125) seed implant combined with transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (MPVTT).

Methods

From December 2016 to February 2018, 26 cases of HCC with MPVTT patients were enrolled in this prospective study. Helical I-125 seed implants were placed into the portal vein through the percutaneous transhepatic route. Subsequently, TACE was performed. Follow-up with enhanced CT was performed every 6–8 weeks and TACE was repeated if the residual or recurrent tumor was found. Treatment response was measured with the modified response evaluation criteria in solid tumors. Complication rates and overall survival were also evaluated.

Results

Implantation and TACE were successful in all patients. There were no grade ≥ 3 complications observed in the patients. The objective response rates (ORR) and disease control rates (DCR) of MPVTT at 3 months after implantation were 42.3% and 84.6%, respectively, whereas ORR and DCR of the liver lesions were 34.6% and 46.2%, respectively. The median overall survival was 10.7 months (95% CI 6.2–15.2 months).

Conclusion

Helical I-125 seed implants can be safely placed into the human main portal vein. Helical I-125 seed implants combined with TACE for HCC with MPVTT are safe and feasible.

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Funding

This study was funded by Jiangsu Provincial Medical Talent funding (No. ZDRCA2016038).

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Author notes

  1. Wansheng Wang and Jian Shen have contributed equally to this work.

Authors and Affiliations

  1. Department of Interventional Radiology, The First Affiliated Hospital, Soochow University, No. 188 Shizi Road, Suzhou, 215006, China

    Wansheng Wang, Jian Shen, Chen Wang, Baosheng Ren, Xiaoli Zhu & Caifang Ni

  2. Department of Vascular and Interventional Radiology, The Third Affiliated Hospital, Shihezi University, Shihezi, 832000, China

    Chen Wang

  3. Department of Interventional Radiology, The Affiliated Changzhou NO. 2 People’s Hospital of Nanjing Medical University, Changzhou, 213000, China

    Baosheng Ren

Authors
  1. Wansheng Wang
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  2. Jian Shen
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  3. Chen Wang
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  4. Baosheng Ren
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  5. Xiaoli Zhu
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  6. Caifang Ni
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Corresponding authors

Correspondence to Xiaoli Zhu or Caifang Ni.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Wang, W., Shen, J., Wang, C. et al. Safety and Feasibility of Helical I-125 Seed Implants Combined with Transcatheter Arterial Chemoembolization in Hepatocellular Carcinomas with Main Portal Vein Tumor Thrombus. Cardiovasc Intervent Radiol 42, 1420–1428 (2019). https://doi.org/10.1007/s00270-019-02256-z

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  • DOI: https://doi.org/10.1007/s00270-019-02256-z

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