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

Sun, Jun‐Hui; Zhou, Tianyu; Zhu, Tian; Zhang, Yuelin; Nie, Chun‐Hui; Ai, Jing; Zhou, Gengui; Zhang, Aibin; Dong, Meng‐Jie; Wang, Weilin; Zheng, Shusen

doi:10.1155/2016/3048261

Cited by 17 publications

(23 citation statements)

References 22 publications

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“…In the present study, a signi cant survival bene t in patients in group A relative to those in group B (342.0 vs 231.0 days). This may be because patients treated with the combination of PVS and endovascular 125 I seed-strip implantation prior to TACE-S achieved better liver function, suggesting that restoring portal vein through and reduction of tumor thrombus burden is associated with improved OS [12,13]. With respect to safety, the most frequent AEs following the combination of PVS and 125 I seed-strip implantation was a transient decrease in liver functionality, likely as a result of injury to the bile duct upon puncture of the portal vein [28].…”

Section: Discussionmentioning

confidence: 99%

“…The required number (N) of 125 I seeds was determined based upon the length (L) of the obstructed portal vein segment in mm per the formula N = L/4.5 + 2 (Shanghai GMS Pharmaceutical Co. Ltd) [13]. The 125 I seeds used in this study were 0.8 mm in diameter, and 4.5 ± 0.5 mm long, with 25.9 MBq of radioactivity and a 59.4-day half-life, primarily emitting 27.4 and 31.4 keV X-rays and 35.5 keV -rays.…”

Section: Pvs Combined With Endovascular 125 I Seed-strip Implantationmentioning

confidence: 99%

“…The use of a portal vein stent (PVS) to reduce portal vein occlusion has been explored in the context of PVTT, and its combination with iodine-125 ( 125 I) seed brachytherapy offers a potentially optimal means of improving PVTT management in HCC patients [13]. There are previous reports showing that this combination could decrease liver toxicity caused by TACE, and the synergic effect or abscopal effect offers better local control and OS [14,15].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Hepatocellular Carcinoma-associated Portal Vein Tumor Thrombus Using Combination of Portal Vein Stent Insertion and Endovascular Lodine-125 Seed-strip Implantation Followed by Transcatheter Arterial Chemoembolization- Sorafenib

et al. 2020

Preprint

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BackgroundTo evaluate the efficacy of portal vein stent (PVS) insertion and endovascular iodine-125 (125I) seed-strip implantation followed by transcatheter arterial chemoembolization (TACE)-sorafenib (PVS-125I-TACE-S) in patients with hepatocellular carcinoma (HCC)-associated portal vein tumor thrombus (PVTT).MethodsThis retrospective analysis was performed on 53 consecutive HCC patients with PVTT between May 2014 and July 2018. Twenty-eight patients were treated via PVS-125I-TACE-S, and 25 patients were treated by TACE-S. Hepatic function, disease control, and overall survival (OS) in both groups were analyzed. The Albumin-Bilirubin (ALBI) score approach was used as a means of evaluating liver function, and a Cox regression analysis was utilized to determine which factors were linked to treatment outcomes.ResultsNo preoperative differences in ALBI scores between groups (P=0.724), nor did these scores at 1-month postoperative (P=0.666). However, these scores were significantly different at 3 (P=0.007) and 6 (P=0.044) months postoperatively. PVS-125I-TACE-S exhibiting higher rates of disease control (71.4% vs. 44.0%, P=0.043) after 6 months of treatment and extended OS duration (342.0 vs 231.0 days, P=0.007). A stratified analysis revealed OS in patients with type II PVTT did not differ significantly (313.0 vs. 321.0 days, P=0.689), but OS with type III did (344.0 vs. 226.0 days, P=0.002). A multivariate analysis revealed that tumor size > 10 cm was independently predictive of poor prognosis (P=0.002), whereas PVS-125I-TACE-S was a predictor of a favorable patient prognosis (P=0.040).ConclusionPVS-125I-TACE-S represents a potentially viable strategy for improving hepatic functionality, disease control, and OS in HCC with type III PVTT.

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Section: Discussionmentioning

confidence: 99%

Section: Pvs Combined With Endovascular 125 I Seed-strip Implantationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment of Hepatocellular Carcinoma-associated Portal Vein Tumor Thrombus Using Combination of Portal Vein Stent Insertion and Endovascular Lodine-125 Seed-strip Implantation Followed by Transcatheter Arterial Chemoembolization- Sorafenib

et al. 2020

Preprint

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“…In recent years, portal vein stenting combined with 125 I implantation has achieved significant effects in treating main portal vein tumor thrombus. Sun et al[13] conducted a study to evaluate the effect of 125 I. In their study, the median survival was 147 d. The cumulative survival rates and stent patency rates at 90, 180, and 360 d were 94.1%, 61.8%, and 32.4% and 97.1% (33/34), 76.9% (24/34), and 29.4% (10/34), respectively[13].…”

Section: Discussionmentioning

confidence: 99%

Stents combined with iodine-125 implantation to treat main portal vein tumor thrombus

Wang

Yue

et al. 2018

WJGO

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AIMTo evaluate the efficacy of main portal vein stents combined with iodine-125 (125I) to treat main portal vein tumor thrombus.METHODSFrom January 1, 2010 to January 1, 2015, 111 patients were diagnosed with liver cancer combined with main portal vein tumor thrombus. They were non-randomly assigned to undergo treatment with transarterial chemoembolization (TACE)/transarterial embolization (TAE) + portal vein stents combined with 125I implantation (Group A) and TACE/TAE + portal vein stents only (Group B). After the operation, scheduled follow-up was performed at 6, 12 and 24 mo. The recorded information included clinical manifestations, survival rate, and stent restenosis rate. Kaplan–Meier curves, log-rank test and Cox regression were used for data analyses.RESULTSFrom January 1, 2010 to January 1, 2015, 54 and 57 patients were allocated to Groups A and B, respectively. The survival rates at 6, 12 and 24 mo were 85.2%, 42.6% and 22.2% in Group A and 50.9%, 10.5% and 0% in Group B. The differences were significant [log rank P < 0.05, hazard ratio (HR): 0.37, 95%CI: 0.24-0.56]. The rates of stent restenosis were 18.5%, 55.6% and 83.3% in Group A and 43.9%, 82.5% and 96.5% in Group B. The differences were significant (log rank P < 0.05, HR: 0.42, 95%CI: 0.27-0.63). Cox regression identified that treatment was the only factor affecting survival rate in this study.CONCLUSIONMain portal vein stents combined with 125I can significantly improve survival rate and reduce the rate of stent restenosis.

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“…If effective treatment is not available, the median survival time of these patients is only 2.7-4.0 months [3]. In recent years, portal vein stenting (PVS) combined with 125 I implantation has achieved significant effects in treating main portal vein tumour thrombus [4][5][6][7]. Stent implantation in the main portal vein can effectively alleviate portal vein pressure, relieve clinical symptoms, and improve quality of life [8].…”

Section: Introductionmentioning

confidence: 99%

Portal Vein Stenting Combined with ¹²⁵I Particle Chain Implantation Followed by As₂O₃ in the Treatment of Hepatocellular Carcinoma with Portal Vein Tumour Thrombus

Jiao

et al. 2020

BioMed Research International

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Objective. To evaluate the feasibility and safety of portal vein stenting (PVS) combined with 125 I particle chain implantation and sequential arsenic trioxide (As 2 O 3 ) for the treatment of hepatocellular carcinoma (HCC) with portal vein tumour thrombus (PVTT) by transcatheter arterial chemoembolization (TACE). Methods. From January 2015 to January 2018, the clinical data of 30 patients with HCC complicated by PVTT were retrospectively analysed (26 men and 4 women). e laboratory examinations, incidence of adverse events, cumulative survival rate, and stent patency were analysed for all enrolled patients. Results. e success rate of interventional treatment in all patients was 100%. e results of the laboratory tests before and 1 week after surgery showed that the mean concentrations of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) decreased from 50.9 U/ L ± 25.8 to 41.8 U/L ± 21.6 (P < 0.001) and 57.6 U/L ± 19.9 to 44.2 U/L ± 26.1 (P < 0.001), respectively. No complications in grade 3 or higher according to the Common Terminology Criteria for Adverse Events (CTCAE) were observed. e cumulative survival rates at 3, 6, 9, and 12 months were 83.1%, 69.2%, 43.7%, and 31.2%, respectively, while the patency rates of the stents were 83.3%, 80.0%, 52.2%, and 38.3%, respectively. Of the 30 deaths during the follow-up period, 16 patients died of liver failure, 8 died of gastrointestinal bleeding, 3 died of lung metastasis, 2 died of brain metastases, and 1 died of heart failure because the tumour invaded the atria. Conclusion. PVS combined with 125 I particle chain implantation followed by TACE with As 2 O 3 is safe and feasible for patients with PVTT. e long-term efficacy of this treatment needs to be further studied.

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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

Cited by 17 publications

References 22 publications

Treatment of Hepatocellular Carcinoma-associated Portal Vein Tumor Thrombus Using Combination of Portal Vein Stent Insertion and Endovascular Lodine-125 Seed-strip Implantation Followed by Transcatheter Arterial Chemoembolization- Sorafenib

Treatment of Hepatocellular Carcinoma-associated Portal Vein Tumor Thrombus Using Combination of Portal Vein Stent Insertion and Endovascular Lodine-125 Seed-strip Implantation Followed by Transcatheter Arterial Chemoembolization- Sorafenib

Stents combined with iodine-125 implantation to treat main portal vein tumor thrombus

Portal Vein Stenting Combined with ¹²⁵I Particle Chain Implantation Followed by As₂O₃ in the Treatment of Hepatocellular Carcinoma with Portal Vein Tumour Thrombus

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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

Cited by 17 publications

References 22 publications

Treatment of Hepatocellular Carcinoma-associated Portal Vein Tumor Thrombus Using Combination of Portal Vein Stent Insertion and Endovascular Lodine-125 Seed-strip Implantation Followed by Transcatheter Arterial Chemoembolization- Sorafenib

Treatment of Hepatocellular Carcinoma-associated Portal Vein Tumor Thrombus Using Combination of Portal Vein Stent Insertion and Endovascular Lodine-125 Seed-strip Implantation Followed by Transcatheter Arterial Chemoembolization- Sorafenib

Stents combined with iodine-125 implantation to treat main portal vein tumor thrombus

Portal Vein Stenting Combined with 125I Particle Chain Implantation Followed by As2O3 in the Treatment of Hepatocellular Carcinoma with Portal Vein Tumour Thrombus

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Portal Vein Stenting Combined with ¹²⁵I Particle Chain Implantation Followed by As₂O₃ in the Treatment of Hepatocellular Carcinoma with Portal Vein Tumour Thrombus