Yu Tian-Zhu, Zhang Wen, Liu Qing-Xin, Li Wen-Hui, Ma Jing-Qin, Zhang Zi-Han, Yang Min-Jie, Wang Jian-Hua, Chen Bing, Zeng Shao-Chong, Luo Jian-Jun, Liu Ling-Xiao, Yan Zhi-Ping
Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Institute of Medical Imaging, Shanghai, China.
Oncotarget. 2017 Feb 14;8(7):12108-12119. doi: 10.18632/oncotarget.14520.
Hepatocellular carcinoma (HCC) patients with main portal vein tumor thrombus have a median survival time of only about 4 months. We therefore compared the safety and efficacy of endovascular brachytherapy (EVBT) and sequential three-dimensional conformal radiotherapy (3-DCRT). From a cohort of 176 patients, we treated 123 with EVBT using iodine-125 seed strands (group A) and the remaining 53 with sequential 3-DCRT (group B). Overall survival, progression free survival and stent patency characteristics were compared between the two groups. Our analysis demonstrated a median survival of 11.7 ± 1.2 months in group A versus 9.5 ± 1.8 months in group B (p = 0.002). The median progression free survival was 5.3 ± 0.7 months in groupA versus 4.4 ± 0.4 months in group B (p = 0.010). The median stent patency period was 10.3 ± 1.1 months in group A versus 8.7 ± 0.7 months in group B (p = 0.003). Therefore, as compared to sequential 3-DCRT, EVBT combined with portal vein stenting and TACE improved overall survival of HCC patients with main portal vein tumor thrombus.
伴有门静脉主干癌栓的肝细胞癌（HCC）患者的中位生存时间仅约4个月。因此，我们比较了血管内近距离放疗（EVBT）与序贯三维适形放疗（3-DCRT）的安全性和疗效。在176例患者队列中，我们用碘-125籽源链对123例患者进行了EVBT治疗（A组），其余53例患者接受序贯3-DCRT治疗（B组）。比较了两组的总生存期、无进展生存期和支架通畅情况。我们的分析显示，A组的中位生存期为11.7±1.2个月，而B组为9.5±1.8个月（p=0.002）。A组的中位无进展生存期为5.3±0.7个月，而B组为4.4±0.4个月（p=0.010）。A组的中位支架通畅期为10.3±1.1个月，而B组为8.7±0.7个月（p=0.003）。因此，与序贯3-DCRT相比，EVBT联合门静脉支架置入和经动脉化疗栓塞（TACE）可提高伴有门静脉主干癌栓的HCC患者的总生存期。
