Chemoembolization and stenting combined with iodine-125 seed strands for the treatment of hepatocellular carcinoma with inferior vena cava obstruction

Li,Wenhui; Dai,Zhenyu; Yao,Lizheng; Luo,Jianjun; Yan,Zhiping

doi:10.3892/etm.2015.2581

Chemoembolization and stenting combined with iodine-125 seed strands for the treatment of hepatocellular carcinoma with inferior vena cava obstruction

Authors:
- Wenhui Li
- Zhenyu Dai
- Lizheng Yao
- Jianjun Luo
- Zhiping Yan
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Affiliations: Department of Interventional Radiology, Yancheng Hospital, Dongnan University, Yancheng, Jiangsu 224001, P.R. China, Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China
Published online on: June 18, 2015 https://doi.org/10.3892/etm.2015.2581
Pages: 973-977

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Abstract

The aim of the present study was to investigate the efficacy and safety of stenting combined with radioactive iodine‑125 seed strands following chemoembolization for the treatment of patients with hepatocellular carcinoma and inferior vena cava (IVC) obstruction. A retrospective analysis was conducted of 52 hepatocellular carcinoma patients with IVC obstruction. All patients received chemoembolization of tumor‑supplying arteries and IVC stents, and 18 patients additionally received iodine‑125 seed strands, which were fixed to the stents. Improvement of IVC obstruction and the tumor response rates were compared between the two groups with a median follow‑up time of 2.5 months. In both groups the stents were successfully deployed. At the 2‑month post‑procedural follow‑up, the mean diameter of the IVC obstruction site, the mean pressure difference between the distal IVC obstructive segment and the right atrium as well as the obstruction scoring did not differ significantly between the two groups. By contrast, the tumor response rate of the iodine‑125 seed strand group was 94.4%, whereas for the group without iodine‑125 seed strands it was 35.3% (P<0.001). The combination of stent and iodine‑125 seed strands was effective and safe for the treatment of hepatocellular carcinoma with IVC obstruction.

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1	Parkin DM, Bray F, Ferlay J and Pisani P: Global cancer statistics, 2002. CA Cancer J Clin. 55:74–108. 2005. View Article : Google Scholar : PubMed/NCBI
2	Tang ZY, Ye SL, Liu YK, et al: A decade's studies on metastasis of hepatocellular carcinoma. J Cancer Res Clin Oncol. 130:187–196. 2004. View Article : Google Scholar : PubMed/NCBI
3	Kato Y, Tanaka N, Kobayashi K, Ikeda T, Hattori N and Nonomura A: Growth of hepatocellular carcinoma into the right atrium. Report of five cases. Ann Intern Med. 99:472–474. 1983. View Article : Google Scholar : PubMed/NCBI
4	Zeng ZC, Fan J, Tang ZY, et al: A comparison of treatment combinations with and without radiotherapy for hepatocellular carcinoma with portal vein and/or inferior vena cava tumor thrombus. Int J Radiat Oncol Biol Phys. 61:432–443. 2005. View Article : Google Scholar : PubMed/NCBI
5	Wu LL, Luo JJ, Yan ZP, et al: Comparative study of portal vein stent and TACE combined therapy with or without endovascular implantation of iodine-125 seeds strand for treating patients with hepatocellular carcinoma and main portal vein tumor thrombus. Zhonghua Gan Zang Bing Za Zhi. 20:915–919. 2012.(In Chinese). PubMed/NCBI
6	Amols HI: Review of endovascular brachytherapy physics for prevention of restenosis. Cardiovasc Radiat Med. 1:64–71. 1999. View Article : Google Scholar : PubMed/NCBI
7	Sidawy AN, Weiswasser JM and Waksman R: Peripheral vascular brachytherapy. J Vasc Surg. 35:1041–1047. 2002. View Article : Google Scholar : PubMed/NCBI
8	Heysek RV: Modern brachytherapy for treatment of prostate cancer. Cancer Control. 14:238–243. 2007.PubMed/NCBI
9	Lazarescu GR and Battista JJ: Analysis of the radiobiology of ytterbium-169 and iodine-125 permanent brachytherapy implants. Phys Med Biol. 42:1727–1736. 1997. View Article : Google Scholar : PubMed/NCBI
10	Nath R, Anderson LL, Luxton G, Weaver KA, Williamson JF and Meigooni AS: Dosimetry of interstitial brachytherapy sources: Recommendations of the AAPM Radiation Therapy Committee Task Group No. 43. Med Phys. 22:209–234. 1995. View Article : Google Scholar : PubMed/NCBI
11	Strasser-Wozak EM, Hartmann BL, Geley S, et al: Irradiation induces G2/M cell cycle arrest and apoptosis in p53-deficient lymphoblastic leukemia cells without affecting Bcl-2 and Bax expression. Cell Death Differ. 5:687–693. 1998. View Article : Google Scholar : PubMed/NCBI
12	Zhuang HQ, Wang JJ, Liao AY, Wang JD and Zhao Y: The biological effect of ¹²⁵I seed continuous low dose rate irradiation in CL187 cells. J Exp Clin Cancer Res. 28:122009. View Article : Google Scholar : PubMed/NCBI
13	Xiang GA, Chen KY, Wang HN and Xiao JF: Immunological influence of iodine-125 implantation in patients with hepatocellular carcinoma resection. Nan Fang Yi Ke Da Xue Xue Bao. 30:292–294. 2010.(In Chinese). PubMed/NCBI
14	Chen K, Xia Y, Wang H, Xiao F, Xiang G and Shen F: Adjuvant iodine-125 brachytherapy for hepatocellular carcinoma after complete hepatectomy: A randomized controlled trial. PLoS One. 8:e573972013. View Article : Google Scholar : PubMed/NCBI
15	Nag S, DeHaan M, Scruggs G, Mayr N and Martin EW: Long-term follow-up of patients of intrahepatic malignancies treated with iodine-125 brachytherapy. Int J Radiat Oncol Biol Phys. 64:736–744. 2006. View Article : Google Scholar : PubMed/NCBI
16	Chuan-Xing L, Xu H, Bao-Shan H, et al: Efficacy of therapy for hepatocellular carcinoma with portal vein tumor thrombus: Chemoembolization and stent combined with iodine-125 seed. Cancer Biol Ther. 12:865–871. 2011. View Article : Google Scholar : PubMed/NCBI
17	Armstrong JG, Anderson LL and Harrison LB: Treatment of liver metastases from colorectal cancer with radioactive implants. Cancer. 73:1800–1804. 1994. View Article : Google Scholar : PubMed/NCBI
18	Martinez-Monge R, Nag S, Nieroda CA and Martin EW: Iodine-125 brachytherapy in the treatment of colorectal adenocarcinoma metastatic to the liver. Cancer. 85:1218–1225. 1999. View Article : Google Scholar : PubMed/NCBI