SIR 2024
Nonvascular Interventions
Zhenkang Qiu, MD, PhD
Physician
The Affiliated Hospital of Qingdao University, China (People's Republic)
Disclosure information not submitted.
Song Wang, MD, PhD
Head of department
The Affiliated Hospital of Qingdao University, China (People's Republic)
Financial relationships: Full list of relationships is listed on the CME information page.
Portal vein tumor thrombus (PVTT) seriously reduces the survival of patients with hepatocellular carcinoma (HCC). CT-guided iodine-125 (125I) brachytherapy has the advantage of a high local control rate and is minimally invasive. This study aims to evaluate the safety and efficacy of 125I brachytherapy for treating PVTT in HCC patients.
Materials and Methods:
Thirty-eight patients diagnosed with HCC complicated with PVTT and treated with 125I brachytherapy for PVTT were included in this retrospective study. The local tumor control rate (LTCR), local tumor progression-free survival (LTPFS), and overall survival (OS) were analyzed. Cox proportional hazards regression analysis was performed to identify predictors affecting survival.
Results: The LTCR was 78.9% (30/38). The median LTPFS was 11.6 (95% confidence interval [CI]: 6.7, 16.5) months, and the median OS was 14.5 (95% CI: 9.2, 19.7) months. Multivariate Cox analysis showed that age < 60 years (hazard ratio [HR] = 0.362; 95% CI: 0.136, 0.965; P = 0.042), type I+II PVTT (HR = 0.065; 95% CI: 0.019, 0.228; P < 0.001), and tumor diameter < 5 cm (HR = 0.250; 95% CI: 0.084, 0.748; P = 0.013) were significant predictors of OS. There were no serious adverse events (AEs) related to 125I seed implantation during the follow-up period.
Conclusion:
CT-guided 125I brachytherapy is effective and safe for treating PVTT of HCC, with a high local control rate and no severe AEs. Patients younger than 60 years old with type I+II PVTT and a tumor diameter less than 5 cm have a more favorable OS.