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Unresectable Hepatocellular Carcinoma with Tumor Thrombus in the First Order Portal Vein Branch Treated by Linear Iodine125 Seeds Strand Implantation Combined with Transarterial Chemoembolization: A Propensity Sore Analysis
Abstracts / Brachytherapy 16 (2017) S14eS118
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MSOR5 Presentation Time: 6:05 PM CT-Guided Iodine-125 Seeds Implantation Combined with Chemotherapy for Locally Advanced Pancreatic Carcinoma Wujie Wang, MD, Yongzheng Wang, MD, Yuliang Li, MD. The Second Hospital of Shandong University, Jinan, China.
were no differences in the incidence of complications between I125stenting and conventional stenting. However,due to the limited quality of the included studies,more high-quality and multicenter studies are needed to verify the above conclusion.
MSOR4 Presentation Time: 6:00 PM Unresectable Hepatocellular Carcinoma with Tumor Thrombus in the First Order Portal Vein Branch Treated by Linear Iodine125 Seeds Strand Implantation Combined with Transarterial Chemoembolization: A Propensity Sore Analysis Zi-Han Zhang, MD, Jian-Jun Luo, MD, Zhi-Ping Yan, MD. Zhongshan Hospital, Fudan University, Shanghai, China. Purpose: To evaluate the safety and efficacy of Iodine125 seeds strand implantation combined with transarterial chemoembolization (TACE) to treat unresectable hepatocellular carcinoma (HCC) complicated with tumor thrombus in the first order portal vein branch. Materials and Methods: This single-center retrospective study involved 76 HCC patients with tumor thrombus in the first order portal vein branch received Iodine125 seeds strand implantation combined with TACE (Group A, n520) and TACE alone (Group B, n556), to compare time to progression (TTP) and overall survival (OS) by propensity-score analysis. Results: During a mean of 11.7 7.3 months (range 1.9 - 46.1 months) follow-up, Group A had longer median TTP and OS than Group B (p ! 0.001). Multivariate Cox analysis revealed that TACE combined with Iodine125 seeds strand implantation treatment strategy was an independent predictor of favorable OS. In the matched cohort, the median OS and TTP were significantly longer in Group A than Group B (19 pairs; OS, 28.0 5.0 vs 8.9 0.3 months, p ! 0.001; median TTP, 22.1 3.5 months vs 6.8 0.5 months, p ! 0.001). Conclusions: Iodine125 seeds strand implantation combined with TACE might be a safe and effective palliative treatment option for tumor thrombus in the first order portal vein branch.
Purpose: To evaluate the feasibility, efficacy and safety of CT-guided iodine-125 seeds implantation combined with chemotherapy for locally advanced pancreatic carcinoma. Materials and Methods: Thirty-two patients (14 males and 18 females; mean age 62 years ,range, 38-82 years) with locally advanced pancreatic cancer were enrolled in this study. Each case was diagnosised by contrastenhanced computed tomography(CT) and biopsy. The tumor was classified as stage III in 7 patients and stage IV in 25 patients according to the TNM staging system (UICC, 2002). A median number of 52 iodine-125 seeds(range, 25-80) were implanted into pancreatic tumor under CT guidance. Postoperative dosimetry was routinely performed for all cases. The actuarial median D90 of the implanted iodine-125 seeds was 120Gy( range, 100-140 Gy). The particle activity ranged from 0.50.8 mCi. In addition, 16 patients received routine gemcitabine chemotherapy 1 week after brachytherapy. Survival time was calculated using the Kaplan-Meier method and difference was assessed with the logrank test. Results: Median follow-up time was 13 months(range, 3-24months). Visual analog scale pain score on 7 days, 1 and 3 months after therapy was decreased from 5.76 1.93 before operation to 2.67 1.03, 1.68 0.84 and 2.06 1.13, respectively (p! 0.05). The tumor response rate was 62.5%(20/32), with an overall local control rate of 87.5% (28/32). The 1-year and 2-year tumor control rates were 88.7% and 79.1% respectively. The median overall survival time of 14 months(95% CI, 10.18-17.82), while the overall 1-,2-year survival rates were 52.1% and 12.2%. The median survival time of patients at stage III was longer than that of those at stage IV (18months vs 10 months, P50.038). In the group of stage IV, The median survival time of patients who received and did not receive chemotherapy after the procedure was 16 months(95% CI, 13.82-18.18) and 9 months(95% CI, 7.38-10.62) respectively (p50.008). No serious complications were observed. Conclusions: Iodine-125 seed implantation provides a safe and effective method to relieve pain, control local tumor growth. Combined with chemotherapy, this procedure prolongs the survival of patients with stage IV pancreatic disease without additional complications.
S47
MSOR5 Presentation Time: 6:05 PM CT-Guided Iodine-125 Seeds Implantation Combined with Chemotherapy for Locally Advanced Pancreatic Carcinoma Wujie Wang, MD, Yongzheng Wang, MD, Yuliang Li, MD. The Second Hospital of Shandong University, Jinan, China.
were no differences in the incidence of complications between I125stenting and conventional stenting. However,due to the limited quality of the included studies,more high-quality and multicenter studies are needed to verify the above conclusion.
MSOR4 Presentation Time: 6:00 PM Unresectable Hepatocellular Carcinoma with Tumor Thrombus in the First Order Portal Vein Branch Treated by Linear Iodine125 Seeds Strand Implantation Combined with Transarterial Chemoembolization: A Propensity Sore Analysis Zi-Han Zhang, MD, Jian-Jun Luo, MD, Zhi-Ping Yan, MD. Zhongshan Hospital, Fudan University, Shanghai, China. Purpose: To evaluate the safety and efficacy of Iodine125 seeds strand implantation combined with transarterial chemoembolization (TACE) to treat unresectable hepatocellular carcinoma (HCC) complicated with tumor thrombus in the first order portal vein branch. Materials and Methods: This single-center retrospective study involved 76 HCC patients with tumor thrombus in the first order portal vein branch received Iodine125 seeds strand implantation combined with TACE (Group A, n520) and TACE alone (Group B, n556), to compare time to progression (TTP) and overall survival (OS) by propensity-score analysis. Results: During a mean of 11.7 7.3 months (range 1.9 - 46.1 months) follow-up, Group A had longer median TTP and OS than Group B (p ! 0.001). Multivariate Cox analysis revealed that TACE combined with Iodine125 seeds strand implantation treatment strategy was an independent predictor of favorable OS. In the matched cohort, the median OS and TTP were significantly longer in Group A than Group B (19 pairs; OS, 28.0 5.0 vs 8.9 0.3 months, p ! 0.001; median TTP, 22.1 3.5 months vs 6.8 0.5 months, p ! 0.001). Conclusions: Iodine125 seeds strand implantation combined with TACE might be a safe and effective palliative treatment option for tumor thrombus in the first order portal vein branch.
Purpose: To evaluate the feasibility, efficacy and safety of CT-guided iodine-125 seeds implantation combined with chemotherapy for locally advanced pancreatic carcinoma. Materials and Methods: Thirty-two patients (14 males and 18 females; mean age 62 years ,range, 38-82 years) with locally advanced pancreatic cancer were enrolled in this study. Each case was diagnosised by contrastenhanced computed tomography(CT) and biopsy. The tumor was classified as stage III in 7 patients and stage IV in 25 patients according to the TNM staging system (UICC, 2002). A median number of 52 iodine-125 seeds(range, 25-80) were implanted into pancreatic tumor under CT guidance. Postoperative dosimetry was routinely performed for all cases. The actuarial median D90 of the implanted iodine-125 seeds was 120Gy( range, 100-140 Gy). The particle activity ranged from 0.50.8 mCi. In addition, 16 patients received routine gemcitabine chemotherapy 1 week after brachytherapy. Survival time was calculated using the Kaplan-Meier method and difference was assessed with the logrank test. Results: Median follow-up time was 13 months(range, 3-24months). Visual analog scale pain score on 7 days, 1 and 3 months after therapy was decreased from 5.76 1.93 before operation to 2.67 1.03, 1.68 0.84 and 2.06 1.13, respectively (p! 0.05). The tumor response rate was 62.5%(20/32), with an overall local control rate of 87.5% (28/32). The 1-year and 2-year tumor control rates were 88.7% and 79.1% respectively. The median overall survival time of 14 months(95% CI, 10.18-17.82), while the overall 1-,2-year survival rates were 52.1% and 12.2%. The median survival time of patients at stage III was longer than that of those at stage IV (18months vs 10 months, P50.038). In the group of stage IV, The median survival time of patients who received and did not receive chemotherapy after the procedure was 16 months(95% CI, 13.82-18.18) and 9 months(95% CI, 7.38-10.62) respectively (p50.008). No serious complications were observed. Conclusions: Iodine-125 seed implantation provides a safe and effective method to relieve pain, control local tumor growth. Combined with chemotherapy, this procedure prolongs the survival of patients with stage IV pancreatic disease without additional complications.