Clinical value of 125I seeds implantation in the treatment of primary liver cancer with portal vein tumor thrombus / 中华核医学与分子影像杂志

ABSTRACT

Objective:To investigate the clinical value of 125I seeds implantation in the treatment of primary liver cancer with portal vein tumor thrombus. Methods:A total of 218 patients (184 males and 34 females, age (53.8±9.2) years) with primary liver cancer with portal vein tumor thrombus between January 2015 and June 2018 were retrospectively analyzed. All patients underwent 125I seeds implantation under CT guidance. CT examination and liver function test were repeated 2-3 months after the implantation, and the portal vein tumor thrombus diameter, liver function parameters and ascites before and after treatment were compared. All patients were followed up for 2-26 months and the survival time were calculated. Paired t test was used for data analysis. Results:Among 218 patients, 8 patients (3.7%) had complete remission of tumor thrombus, 111 patients (50.9%) had partial remission, 80 patients (36.7%) had no change, and 19 patients (8.7%) had disease progression 2-3 months after the implantation. The total effective rate was 91.3%(199/218). The diameter of tumor thrombus after treatment was (12.63±4.64) mm, which was significantly smaller than that before treatment ((26.65±10.88) mm; t=18.74, P<0.01); serum bilirubin, the direct bilirubin after treatment were different compared with those before treatment (20.59±10.29) vs (24.27±12.65) pg/L ( t=5.37, P<0.05), (11.40±8.37) vs (15.64±7.99) pg/L ( t=8.44, P<0.05); the indirect bilirubin after treatment was not significantly different from that before treatment ( t=0.85, P>0.05). Ascites in 86/142 patients were better after the implantation. No serious complications associated with treatment were seen. There were 162 patients died and 56 patients survived till the end of follow-up. The survival time of all patients was (9.23±0.59) months. Conclusion:125I seeds implantation can safely and effectively treat the portal vein tumor thrombus in patients with primary liver cancer, and improve the clinical symptoms such as ascites.