ABSTRACT
Objective:To compare the preliminary clinical efficacy of iodized oil embolization and improved microspheres injection embolization in patients with hepatic metastasis from gastrointestinal tumors.Methods:In total 100 patients with hepatic metastasis from gastrointestinal tumors were perspective enrolled from July 2015 to July 2017 in the First Affiliated Hospital of Henan University of Science and Technology. The patients were randomly divided into iodized oil group (45 cases) and microspheres group (55 cases) using random number table. The patients in iodized oil group were firstly received regular perfusion chemotherapy, then underwent the embolization with Iodized oil and epirubicin emulsifier. As for the microspheres group, the patients were received epirubicin and microspheres perfusion and embolization alternately after the same regular perfusion chemotherapy. The post-operation complications were observed. The effective rate of tumor controling at each time point was compared between two groups using χ 2 test. Kaplan-Meier method was used to perform the survival analysis. Log-rank test was used to compare the survival rate between two groups. Results:The operation was successfully performed in all the patients, without severe complications found. The follow up time was 18.7±3.4 months. The tumor control rates of 1, 3, 6, 12 and 24 months after operation in the iodine oil group were 71.1% (32/45), 68.9% (31/45), 51.1% (23/45), 28.9% (13/45), 6.7% (3/45) respectively; while in microspheres group were 90.9% (50/55), 89.1% (49/55), 72.7% (40/55), 49.1% (27/55), 23.6% (13/55), respectively. The tumor control rate in microspheres group was superior to that in iodine oil group ( P<0.05). The median lifetime was 12 months and 17 months for iodine oil group and microspheres group respectively, with significant difference (χ2=8.238, P=0.004) found between two groups. As for the microspheres group, the liver abscess was found in one week after operation in 4 patients, who were cured after drainage and anti-inflammatory treatment. Conclusion:The improved microspheres injection embolization is an effective method for the hepatic metastasis from gastrointestinal tumors and superior to iodized oil embolization in tumor controlling, which may prolong the median survival time.
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Objective To evaluate the efficacy and safety of 125I seed implantation combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary hepatocellular carcinoma (PHC).Methods 156 patients who had unresectable PHC seen from January 2012 to December 2015 in our unit were randomly assigned into the study group (76 patients) and the control group (80 patients).The study group of patients were treated with intra-hepatic implantation of 125I seed + TACE,and the control group of patients were treated with three dimensional conformal radiotherapy (3DCRT) + TACE.After ra diotherapy the two groups of patients underwent 2 to 3 times TACE treatment.The biomarker levels were compared between the two groups before and after treatment,and the short-term efficacy,clinical safety and 1 year survival rates were assessed.Results The success rates of the treatment for the two groups were both 100％.Patients in the study group were implanted with 1 016 125I seeds,with an average of (13.7 ± 2.5) seeds per patient.The two groups had no significant difference on short-term efficacy (P ＞ 0.05).The DCR,ORR and 1 year survival rates in the study group were 63.2％,92.1％,55.5％,and they were 61.3％,90.0％,58.1％ in the control group,respectively.There were no significant differences between these 2 groups (P ＞ 0.05).At 1 month after treatment,the two groups had no significant differences onAFP,IGF-Ⅱ and IGFBP-2 [(5.08±0.85) μg/L vs.(5.12 ±0.79) μg/L,(4.77 ±0.58) μg/L vs.(4.86 ±0.53) μg/L,(4.98 ±0.67) μg/L vs.(5.04 ±0.71) μg/L] (P＞0.05).There were no signif-icant differences on chemotherapy drug toxicities between the two groups (P ＞ 0.05).The incidence of radi-ation hepatitis in the study group was 1.3％,while the incidences of radiation dermatitis,hepatitis,gastriculcer in the control group were 5.0％,8.8％,2.5％,respectively.The radiation dermatitis incidence inthe study group was significantly lower than that of the control group (P ＜ 0.05).In the study group,2 pa-tients (2.6％) had their 125I seed slightly moved.Conclusion The short-term efficacy of 125I seed implan-tation plus TACE in the treatment of PHC is no less than the 3DCRT + TACE regimen,but with less radia-tion side effects.
ABSTRACT
Objective To evaluate the efficacy and safety of treating liver cancer using 131I-anti-CD147-monoclonal-antibody (131I-anti- CD147-McAb) by transcatheter hepatic arterial infusion (TAI) in a rabbit liver cancer model. Methods Forty-five rabbit models were randomly divided into three groups evenly. Transcatheter hepatic artery infusion under general anesthesia were performed in all three groups. Group A:control group, saline. Group B:pure 131I solution. Group C: 131I-anti-CD147-McAb solution. About 2 ml blood sample was obtained from all rabbits for liver, kidney,and thyroid function at pre-TAI and post-TAI 1 day, 3 days ,7 days, 14 days, 21 days. The rabbits were scanned by single photon emission computed tomographic (SPECT) to monitor radionuclide bio-distribution and tumor size on 1 day, 7 days, 14 days, 21days after procedures in group B and C. On 14 days after procedure, five rabbits were randomly selected to be sacrificed in each group for pathological and immunological investigations. The remaining rabbits continued to be fed, and survival rates were measured. Results The TAI and SPECT-CT/CT procedures were successfully performed in all rabbits. Test results showed that AST and ALT levels tended to increase transiently 1 day after TAI (P 0.05) 7 days after TAI. FT3 and FT4 mean values of rabbits in group B and C continued to decline 7 days after TAI, while thyroid stimulating hormone (TSH) showed corresponding increase (P0.05). SPEC-CT imaging of rabbits shows that most of the radionuclide was gathered in the gastrointestinal tract and thyroid in Group B, however, radionuclide was mainly concentrated in the tumor lesions in Group C. Fourteen days after procedures, radionuclide imaging of all rabbits disappeared in group B and C. The VX2 liver tumors increased rapidly after treatment in group A and B;but the tumors gradually reduced their size in group C. At 14 days after TAI: The proportion of tumor necrosis in group C was significantly greater than that in groups A and B (P<0.05). The microvessel density (MVD) number of residual tumor in group C was less than groups A or B (P<0.05).TUNEL analysis suggested that more apoptosis bodies was displayed in the residual tumor tissue in group C than that in groups A and B, but the expression of MMP-2 and vessel endothelial grouth factor (VEGF) was significantly reduced in group C than group A and group B. Median survival time of the rabbits in groups A, B, C was 22 days, 26 days and 54 days respectively. Survival time of the rabbits in group C was significantly prolonged than other two groups (P<0.01). Conclusions Radioimmunotherapy with 131I-anti-CD147-McAb by TAI can inhibit the growth and metastasis of liver cancer, and prolong the survival of experimental animals. The method is effective and safe in this animal study.