To explore the curative effect of CT-guided Iodine-125 radioactive seed implantation in the treatment of stage Ⅳprimary hepatocellular carcinoma

Fuqiang Zhang; Lin Zheng; Deyu Li; Hui Yang

doi:10.1016/j.jimed.2021.02.009

To explore the curative effect of CT-guided Iodine-125 radioactive seed implantation in the treatment of stage Ⅳprimary hepatocellular carcinoma

J Interv Med. 2021 Feb 27;4(2):82-86. doi: 10.1016/j.jimed.2021.02.009. eCollection 2021 May.

Authors

Fuqiang Zhang¹, Lin Zheng², Deyu Li¹, Hui Yang¹

Affiliations

¹ Department of Nuclear Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450003, China.
² Department of Minimally Invasive & Interventional, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450003, China.

Abstract

Objectives: To explore the clinical efficacy and survival of CT-guided Iodine-125 radioactive seed implantation in the treatment of stage Ⅳ primary hepatocellular carcinoma.

Methods: A retrospective study of 62 patients with primary hepatocellular carcinoma in our hospital from January 2017 to December 2018 [60 males, 2 females, age (52.76 ± 10.82) years old], All patients were implanted with Iodine-125 radioactive seeds under CT guidance, followed up regularly after operation to observe the clinical efficacy, including comparison of changes in cancer size before and after treatment, tumor marker AFP, and improvement in complications such as abdominal pain and ascites. Follow-up 3-36 months to assess patient survival.

Results: Among the 62 patients, 3 months after Iodine-125 radioactive seed implantation, 5 cases (8.1%) had complete remission of cancer, 33 cases (53.2%) had partial remission, 12 cases (19.4%) had stable lesions, and 12 cases (19.4%) had disease progression. The effective rate was 61.3%. The tumor volume (31.44 ± 14.51cm3) was significantly smaller than before (50.96 ± 30.13cm3) (t = 5.303, p < 0.05). The tumor marker AFP (69.28 ± 50.99) ug/L of 3 months after implantation was significantly lower than that before treatment (90.63 ± 68.58) ug/L (t = 3.702, P < 0.05). The average survival time of Iodine-125 seed implantation for stageⅣhepatocellular carcinoma is 11.47 ± 0.85 months, and the median survival time is 9 months. The survival time of the group with better pathological differentiation (gradeⅠ+Ⅱ) was significantly better than that of the group with poor differentiation (grade Ⅲ+Ⅳ) (x2 = 6.869 p < 0.05). Among the 38 patients with different degrees of abdominal pain, 22 patients improved better than before; 15 of 28 patients with different degrees of ascites were better than before. All patients had no serious complications related to treatment.

Conclusions: Iodine-125 radioactive seed implantation therapy can safely and effectively treat hepatocellular carcinoma, and relieve the clinical symptoms of abdominal pain and ascites.

Keywords: Brachytherapy; Hepatocellular carcinoma; Interventional therapy; Iodine-125; Radioactive seed.