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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 9/2016

01-09-2016 | Clinical Investigation

TACE Combined with Implantation of Irradiation Stent Versus TACE Combine with Bare Stent for HCC Complicated by IVCTT

Authors: Qing-hui Yang, Wen Zhang, Qing-xin Liu, Ling-xiao Liu, Lin-lin Wu, Jian-hua Wang, Zhi-ping Yan, Jian-jun Luo

Published in: CardioVascular and Interventional Radiology | Issue 9/2016

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Abstract

Purpose

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 125I 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.
Literature
1.
2.
Tsuzuki T, Ogata Y, Iida S, Shimazu M. Hepatic resection in 125 patients. Arch Surg. 1984;119(9):1025–32.CrossRefPubMed
3.
Llovet JM, Bustamante J, Castells A, Vilana R, Ayuso MD, Sala M, et al. Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials. Hepatology. 1999;29(1):62–7.CrossRefPubMed
4.
Fong Y, Sun RL, Jarnagin W, Blumgart LH. An analysis of 412 cases of hepatocellular carcinoma at a Western center. Ann Surg. 1999;229(6):790–9 (discussion 799–800).CrossRefPubMedPubMedCentral
5.
Li AJ, Zhou WP, Lin C, Lang XL, Wang ZG, Yang XY, et al. Surgical treatment of hepatocellular carcinoma with inferior vena cava tumor thrombus: a new classification for surgical guidance. Hepatobiliary Pancreat Dis Int. 2013;12(3):263–9.CrossRefPubMed
6.
Hemming AW, Mekeel KL, Zendejas I, Kim RD, Sicklick JK, Reed AI. Resection of the liver and inferior vena cava for hepatic malignancy. J Am Coll Surg. 2013;217(1):115–24 (discussion 124–125).CrossRefPubMed
7.
Jung H, Lee KU, Shin WY, Ahn H. Treatment outcomes of surgical resection for hepatocellular carcinoma with inferior vena cava invasion and/or thrombosis. Hepato-gastroenterology. 2011;58(110–111):1694–9.PubMed
8.
9.
Yoo DJ, Kim KM, Jin YJ, Shim JH, Ko GY, Yoon HK, et al. Clinical outcome of 251 patients with extrahepatic metastasis at initial diagnosis of hepatocellular carcinoma: does transarterial chemoembolization improve survival in these patients? J Gastroenterol Hepatol. 2011;26(1):145–54.CrossRefPubMed
10.
Chung GE, Lee JH, Kim HY, Hwang SY, Kim JS, Chung JW, et al. Transarterial chemoembolization can be safely performed in patients with hepatocellular carcinoma invading the main portal vein and may improve the overall survival. Radiology. 2011;258(2):627–34.CrossRefPubMed
11.
Chern MC, Chuang VP, Cheng T, Lin ZH, Lin YM. Transcatheter arterial chemoembolization for advanced hepatocellular carcinoma with inferior vena cava and right atrial tumors. Cardiovasc Interv Radiol. 2008;31(4):735–44.CrossRef
12.
Xi M, Zhang L, Zhao L, Li QQ, Guo SP, Feng ZZ, et al. Effectiveness of stereotactic body radiotherapy for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombosis. PLoS ONE. 2013;8(5):e63864.CrossRefPubMedPubMedCentral
13.
Koo JE, Kim JH, Lim YS, Park SJ, Won HJ, Sung KB, et al. Combination of transarterial chemoembolization and three-dimensional conformal radiotherapy for hepatocellular carcinoma with inferior vena cava tumor thrombus. Int J Radiat Oncol Biol Phys. 2010;78(1):180–7.CrossRefPubMed
14.
Sugiyama S, Beppu T, Ishiko T, Takahashi M, Masuda T, Hirata T, et al. Efficacy of radiotherapy for PV and IVC tumor thrombosis in unresectable HCC. Hepato-gastroenterology. 2007;54(78):1779–82.PubMed
15.
Kudo H, Yata Y, Orihara T, Kageyama M, Takahara T, Sugiyama T. Malignant inferior vena cava syndrome. Intern Med. 2006;45(4):219–20.CrossRefPubMed
16.
Brountzos EN, Binkert CA, Panagiotou IE, Petersen BD, Timmermans H, Lakin PC. Clinical outcome after intrahepatic venous stent placement for malignant inferior vena cava syndrome. Cardiovasc Interv Radiol. 2004;27(2):129–36.CrossRef
17.
Fletcher WS, Lakin PC, Pommier RF, Wilmarth T. Results of treatment of inferior vena cava syndrome with expandable metallic stents. Arch Surg. 1998;133(9):935–8.CrossRefPubMed
18.
Zhang W, Yan Z, Luo J, Fang Z, Wu L, Liu Q, et al. Iodine-125 seeds strand for treatment of tumor thrombus in inferior vena cava: an experimental study in a rabbit model. Cardiovasc Interv Radiol. 2013;36(5):1371–82.CrossRef
19.
Chen Y, Wang XL, Yan ZP, Wang JH, Cheng JM, Gong GQ, et al. The use of 125I seed strands for intraluminal brachytherapy of malignant obstructive jaundice. Cancer Biother Radiopharm. 2012;27(5):317–23.CrossRefPubMed
20.
Luo J, Yan Z, Liu Q, Qu X, Wang J. Endovascular placement of iodine-125 seed strand and stent combined with chemoembolization for treatment of hepatocellular carcinoma with tumor thrombus in main portal vein. J Vasc Interv Radiol. 2011;22(4):479–89.CrossRefPubMed
21.
Yang M, Fang Z, Yan Z, Luo J, Liu L, Zhang W, et al. Transarterial chemoembolization (TACE) combined with endovascular implantation of an iodine-125 seed strand for the treatment of hepatocellular carcinoma with portal vein tumour thrombosis versus TACE alone: a two-arm, randomised clinical trial. J Cancer Res Clin Oncol. 2014;140(2):211–9. doi:10.​1007/​s00432-013-1568-0.CrossRefPubMed
22.
23.
Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis. 2010;30(1):52–60.CrossRefPubMed
24.
Nath R, Anderson LL, Luxton G, Weaver KA, Williamson JF, Meigooni AS. Dosimetry of interstitial brachytherapy sources: recommendations of the AAPM Radiation-Therapy Committee Task Group No 43. Med Phys. 1995;22(2):209–34. doi:10.​1118/​1.​597458.CrossRefPubMed
25.
Lin ZY, Lin J, Lin C, Li YG, Chen SM, Hu JP, et al. 1.5T conventional MR-guided iodine-125 interstitial implants for hepatocellular carcinoma: feasibility and preliminary clinical experience. Eur J Radiol. 2012;81(7):1420–5.CrossRefPubMed
26.
Zhang FJ, Li CX, Jiao DC, Zhang NH, Wu PH, Duan GF, et al. CT guided 125iodine seed implantation for portal vein tumor thrombus in primary hepatocellular carcinoma. Chin Med J. 2008;121(23):2410–4 (Engl).PubMed
27.
Nag S, DeHaan M, Scruggs G, Mayr N, Martin EW. Long-term follow-up of patients of intrahepatic malignancies treated with iodine-125 brachytherapy. Int J Radiat Oncol Biol Phys. 2006;64(3):736–44.CrossRefPubMed
28.
Sidawy AN, Weiswasser JM, Waksman R. Peripheral vascular brachytherapy. J Vasc Surg. 2002;35(5):1041–7.CrossRefPubMed
29.
Bottcher HD, Schopohl B, Liermann D, Kollath J, Adamietz IA. Endovascular irradiation–a new method to avoid recurrent stenosis after stent implantation in peripheral arteries: technique and preliminary results. Int J Radiat Oncol Biol Phys. 1994;29(1):183–6.CrossRefPubMed
30.
Sindelar WF, Kinsella TJ. Normal tissue tolerance to intraoperative radiotherapy. Surg Oncol Clin N Am. 2003;12(4):925–42.CrossRefPubMed
Metadata
Title
TACE Combined with Implantation of Irradiation Stent Versus TACE Combine with Bare Stent for HCC Complicated by IVCTT
Authors
Qing-hui Yang
Wen Zhang
Qing-xin Liu
Ling-xiao Liu
Lin-lin Wu
Jian-hua Wang
Zhi-ping Yan
Jian-jun Luo
Publication date
01-09-2016
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 9/2016
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-016-1372-8

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