Clinical effect of transarterial chemoembolization combined with endovascular implantation of iodine-125 seeds in treatment of primary liver cancer complicated by portal vein tumor thrombus / 临床肝胆病杂志

ABSTRACT

Objective To investigate the clinical effect of transarterial chemoembolization (TACE) combined with endovascular implantation of iodine-125 seeds in the treatment of primary liver cancer complicated by portal vein tumor thrombus (PVTT) and its influence on liver function. Methods A retrospective analysis was performed for the clinical data of 96 patients with primary liver cancer complicated by PVTT who were admitted to Guangzhou No. 12 People's Hospital from January 2013 to December 2016. Among these patients, 52 were treated with TACE combined with endovascular implantation of iodine-125 seeds in the portal vein (combination group) and 44 were treated with TACE alone (control group) . The two groups were compared in terms of the outcome of tumor lesions and PVTT and the changes in related laboratory markers after treatment. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Results Compared with the control group, the combination group had significantly higher remission rates of tumor lesions (59. 62％ vs 38. 64％, χ2= 4. 196, P = 0. 041) and PVTT (80. 77％ vs 59. 09％, χ2=5. 421, P = 0. 020) . At 8 weeks after surgery, the combination group had significantly lower serum alpha-fetoprotein (AFP), diameter of the main portal vein, and platelet count (PLT) and significantly higher serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBil) than the control group (t = 3. 891, 3. 291, 2. 330, 3. 729, 3. 582, and 4. 126, all P ＜0. 05); both groups showed significant increases in serum levels of ALT, AST, and TBil (all P ＜ 0. 05) and significant reductions in PLT, serum AFP and diameter of the main portal vein (all P ＜ 0. 05) . Conclusion TACE combined with endovascular implantation of iodine-125 seeds in the portal vein has a better clinical effect than TACE alone in the treatment of primary liver cancer complicated by PVTT, but more attention should be paid to liver impairment during treatment.