125I Irradiation Stent for Hepatocellular Carcinoma with Main Portal Vein Tumor Thrombosis: A Systematic Review
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A systematic review was conducted to provide an overview of the efficacy and safety of 125I irradiation stent placement for patients with hepatocellular carcinoma (HCC) and main portal vein tumor thrombosis (MPVTT). Six studies with 406 patients were included in the final analysis. The median overall survival for patients treated with 125I irradiation stent placement was 10.3 months. The most common radiation-related adverse event was leukopenia. The stent-related adverse events consisted of fever, abdominal pain, hemorrhage, and anorexia. No stent or seed migration was reported. Overall, the use of an 125I irradiation stent has the potential to act as an alternative therapy for patients with HCC with MPVTT.
KeywordsHepatocellular carcinoma Portal vein tumor thrombosis Radioactive stent Endovascular brachytherapy Systematic review
This study was supported by the National Natural Science Foundation of China (81901847) and the Suzhou Science and Technology Youth Plan (KJXW2018003). Funding source had no involvement in the financial support for the conduct of the research and preparation of the article.
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On behalf of all authors, the corresponding authors state that there is no conflict of interest.
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This article does not contain any studies with human participants or animals performed by any of the authors.
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- 3.Lee SW, Lee HL, Han NI, Kwon JH, Nam SW, Jang JW, et al. Transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil versus transarterial chemoembolization using doxorubicin for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a retrospective analysis. Ther Adv Med Oncol. 2017;9(10):615–26. https://doi.org/10.1177/1758834017728018.CrossRefPubMedPubMedCentralGoogle Scholar
- 5.Llovet JM, Bustamante J, Castells A, Vilana R, Ayuso Mdel C, 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. https://doi.org/10.1002/hep.510290145.CrossRefPubMedGoogle Scholar
- 7.Cheng AL, Kang YK, Chen Z, Tsao CJ, Qin S, Kim JS, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol. 2009;10(1):25–34. https://doi.org/10.1016/S1470-2045(08)70285-7.CrossRefPubMedGoogle Scholar
- 9.Cheng AL, Guan Z, Chen Z, Tsao CJ, Qin S, Kim JS, et al. Efficacy and safety of sorafenib in patients with advanced hepatocellular carcinoma according to baseline status: subset analyses of the phase III Sorafenib Asia-Pacific trial. Eur J Cancer. 2012;48(10):1452–65. https://doi.org/10.1016/j.ejca.2011.12.006.CrossRefPubMedGoogle Scholar
- 13.Inarrairaegui M, Thurston KG, Bilbao JI, D'Avola D, Rodriguez M, Arbizu J, et al. Radioembolization with use of yttrium-90 resin microspheres in patients with hepatocellular carcinoma and portal vein thrombosis. J Vasc Interv Radiol. 2010;21(8):1205–12. https://doi.org/10.1016/j.jvir.2010.04.012.CrossRefPubMedGoogle Scholar
- 14.Vilgrain V, Pereira H, Assenat E, Guiu B, Ilonca AD, Pageaux GP, et al. Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma (SARAH): an open-label randomised controlled phase 3 trial. Lancet Oncol. 2017;18(12):1624–36. https://doi.org/10.1016/S1470-2045(17)30683-6.CrossRefPubMedGoogle Scholar
- 19.Zhu HD, Guo JH, Mao AW, Lv WF, Ji JS, Wang WH, et al. Conventional stents versus stents loaded with (125)iodine seeds for the treatment of unresectable oesophageal cancer: a multicentre, randomised phase 3 trial. Lancet Oncol. 2014;15(6):612–9. https://doi.org/10.1016/S1470-2045(14)70131-7.CrossRefPubMedGoogle Scholar
- 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. https://doi.org/10.1016/j.jvir.2010.11.029.CrossRefPubMedGoogle Scholar
- 21.Lu J, Guo JH, Zhu HD, Zhu GY, Chen L, Teng GJ. Safety and efficacy of irradiation stent placement for malignant portal vein thrombus combined with transarterial chemoembolization for hepatocellular carcinoma: a single-center experience. J Vasc Interv Radiol. 2017;28(6):786–94.e3. https://doi.org/10.1016/j.jvir.2017.02.014.CrossRefPubMedGoogle Scholar
- 23.Wells GA SB, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2015. https://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.
- 24.Zhang ZH, Liu QX, Zhang W, Ma JQ, Wang JH, Luo JJ, et al. Combined endovascular brachytherapy, sorafenib, and transarterial chemobolization therapy for hepatocellular carcinoma patients with portal vein tumor thrombus. World J Gastroenterol. 2017;23(43):7735–45. https://doi.org/10.3748/wjg.v23.i43.7735.CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Yu TZ, Zhang W, Liu QX, Li WH, Ma JQ, Zhang ZH, et al. Endovascular brachytherapy combined with portal vein stenting and transarterial chemoembolization improves overall survival of hepatocellular carcinoma patients with main portal vein tumor thrombus. Oncotarget. 2017;8(7):12108–19. https://doi.org/10.18632/oncotarget.14520.CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Sun JH, Zhou T, Zhu T, Zhang Y, Nie C, Ai J, et al. Portal vein stenting combined with Iodine-125 seeds endovascular implantation followed by transcatheter arterial chemoembolization for treatment of hepatocellular carcinoma patients with portal vein tumor thrombus. Biomed Res Int. 2016;2016:3048261. https://doi.org/10.1155/2016/3048261.CrossRefPubMedPubMedCentralGoogle Scholar
- 29.Wang K, Guo WX, Chen MS, Mao YL, Sun BC, Shi J, et al. Multimodality treatment for hepatocellular carcinoma with portal vein tumor thrombus: a large-scale, multicenter, propensity mathching score analysis. Medicine (Baltimore). 2016;95(11):e3015. https://doi.org/10.1097/MD.0000000000003015.CrossRefGoogle Scholar
- 30.Zhang XP, Gao YZ, Chen ZH, Chen MS, Li LQ, Wen TF, et al. An eastern hepatobiliary surgery hospital/portal vein tumor thrombus scoring system as an aid to decision making on hepatectomy for hepatocellular carcinoma patients with portal vein tumor thrombus: a multicenter study. Hepatology. 2018. https://doi.org/10.1002/hep.30490.CrossRefPubMedPubMedCentralGoogle Scholar
- 33.Zhu HD, Guo JH, Zhu GY, He SC, Fang W, Deng G, et al. A novel biliary stent loaded with (125)I seeds in patients with malignant biliary obstruction: preliminary results versus a conventional biliary stent. J Hepatol. 2012;56(5):1104–11. https://doi.org/10.1016/j.jhep.2011.12.018.CrossRefPubMedGoogle Scholar