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Endovascular brachytherapy combined with stent placement and TACE for treatment of HCC with main portal vein tumor thrombus

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Abstract

Propose

To evaluate the safety and efficacy of endovascular brachytherapy (EVBT) with iodine-125 (125I) seed strand implantation combined with stent placement and transarterial chemoembolization (TACE) to treat hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (MPVTT).

Methods

Data of 276 consecutive HCC patients with MPVTT treated by stent placement and TACE were analyzed retrospectively. 125I seed strands were implanted in 182 patients (group A). The remaining 94 patients, who did not receive EVBT, served as control (group B). The overall survival, free of disease progression survival, stent patency period and procedure-related complications were compared between the two groups.

Results

During a mean 9.9 ± 9.7 month (range 1.3–62.2 months) follow-up, the median survival time was 9.3 ± 0.9 months (95 % CI 7.6–11.0 months) in group A compared to 4.9 ± 0.5 months (95 % CI 4.0–5.8 months) in group B (p < 0.001). Median free of disease progression survival time in group A and B was 1.8 ± 0.1 months (95 % CI 1.6–2.0 months) and 1.5 ± 0.1 months (95 % CI 1.3–1.7 months), respectively (p < 0.001). Median stent patency period was 9.2 ± 1.1 months (95 % CI 7.0–11.4 months) in group A and 4.8 ± 0.5 months (95 % CI 3.9–5.7 months) in group B, respectively (p < 0.001).

Conclusion

These findings suggested that EVBT combined with stent placement and TACE might be a safe and effective palliative treatment option for HCC with main portal vein tumor thrombus.

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Abbreviations

EVBT:

Endovascular brachytherapy

125I:

Iodine-125

TACE:

Transarterial chemoembolization

HCC:

Hepatocellular carcinoma

MPV:

Main portal vein

MPVTT:

Main portal vein tumor thrombus

CT:

Computed tomography

AFP:

Alpha-fetoprotein

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Acknowledgements

This work was supported by the project of Advanced and Appropriate Technique Generalization from Shanghai Health and Family Planning Committee (2013SY060).

Author contribution

Study concept and design by JJL and ZPY; acquisition of data by ZHZ and WZ; analysis and interpretation of data by JJL, JHW and QXL; obtained funding by JJL and ZPY.

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    Authors and Affiliations

    1. Department of Interventional Radiology, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, 200032, Shanghai, China

      Jian-Jun Luo, Zi-Han Zhang, Qing-Xin Liu, Wen Zhang, Jian-Hua Wang & Zhi-Ping Yan

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    1. Jian-Jun Luo
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    2. Zi-Han Zhang
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    3. Qing-Xin Liu
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    4. Wen Zhang
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    Correspondence to Zhi-Ping Yan.

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    Conflict of interest

    Jian-Jun Luo, Zi-Han Zhang, Qing-Xin Liu, Jian-Hua Wang and Zhi-Ping Yan declare that they have no conflict of interest.

    Ethical standards

    All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Zhongshan Hospital, Fudan University, China) and the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.

    Additional information

    Jian-Jun Luo, Zi-Han Zhang and Qing-Xin Liu have contributed equally to this work.

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    Luo, JJ., Zhang, ZH., Liu, QX. et al. Endovascular brachytherapy combined with stent placement and TACE for treatment of HCC with main portal vein tumor thrombus. Hepatol Int 10, 185–195 (2016). https://doi.org/10.1007/s12072-015-9663-8

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    • DOI: https://doi.org/10.1007/s12072-015-9663-8

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