Portal 125I seed stent implantation combined with drug-loaded microsphere embolization for the treatment of HCC: initial results in 7 patients / 介入放射学杂志

ABSTRACT

Objective To investigate the feasibility and safety of portal 125I seed stent implantation combined with doxorubicin-eluting beads transcatheter arterial chemoembolization (DEB-TACE) for the treatment of hepatocellular carcinoma (HCC) associated with main portal vein tumor thrombus (MPVTF).Methods Prospective single-arm study was designed.Seven HCC patients with MPVTT were sequentially enrolled in this study to receive treatment.Portal pressure before and after portal vein stent implantation were determined,the liver function were tested before and 1-3 days,4 days,5-7 days after portal vein stent implantation,the results and the postoperative complications were analyzed.Results All 7 patients were in BCLC-C stage,with Child-Pugh classification being A-B level.All patients were diagnosed as massive type HCC complicated by portal vein tumor thrombus.The lesions were located in hepatic left lobe (n=l) and hepatic right lobe (n=6),tumor thrombus in left branch of portal vein was seen in one patient and tumor thrombus in right branch of portal vein was found in 6 patients,MPVTT was observed in all 7 patients.Portal 125I seed stent implantation plus DEB-TACE was successfully accomplished in all 7 patients.The portal pressure before and after stent implantation was 15.3 cmH2O and 10.2 cmH2O respectively,the postoperative pressure showed an obvious reduction.After stent implantation,a transient elevation of the serum total bilirubin (TB),alanine aminotransferase (ALT) and aspartate aminotransferase (AST) could be observed,which gradually decreased in 3-4 days;the recovery of TB level was slower than that of ALT and AST levels.Two patients had concomitant myocardial damage,which was gradually recovered in 2-3 days.Conclusion For the treatment of HCC associated with MPVTT,portal 125I seed stent implantation plus DEB-TACE is safe and feasible,although its long-term curative effect needs to be further clarified.