CardioVascular and Interventional Radiology

, Volume 42, Issue 10, pp 1420–1428 | Cite as

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

  • Wansheng Wang
  • Jian Shen
  • Chen Wang
  • Baosheng Ren
  • Xiaoli ZhuEmail author
  • Caifang NiEmail author
Clinical Investigation Interventional Oncology



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).


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.


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).


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.


Hepatocellular carcinoma MPVTT Helical I-125 seed implant Endovascular brachytherapy TACE 



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

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

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.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Consent for publication was obtained for every individual person’s data included in the study.


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© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  1. 1.Department of Interventional Radiology, The First Affiliated HospitalSoochow UniversitySuzhouChina
  2. 2.Department of Vascular and Interventional Radiology, The Third Affiliated HospitalShihezi UniversityShiheziChina
  3. 3.Department of Interventional RadiologyThe Affiliated Changzhou NO. 2 People’s Hospital of Nanjing Medical UniversityChangzhouChina

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