Department of Radiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China.
Department of Cardiology, Zhejiang Provincial People's Hospital, Hangzhou, 310000, Zhejiang Province, China.
Sci Rep. 2017 Jun 16;7(1):3689. doi: 10.1038/s41598-017-03831-5.
This study evaluated if iodine-125 brachytherapy prophylaxis after radiofrequency ablation (RFA) prolongs time to recurrence (TTR) and overall survival (OS) of patients in high risk of locoregional hepatocellular carcinoma (HCC) recurrence. 116 patients with total tumor necrosis after RFA were divided into iodine-125 brachytherapy prophylaxis treatment group and control group. The primary endpoint was TTR, and secondary endpoints were OS and treatment-related adverse events. There were no significant differences among the baseline characteristics of two subgroups patients. The mean iodine-125 particles were 29.8 (26.59 ± 12.51 mCi) per patient. The mean follow-up was 25 months, and mean TTR of treatment and control groups were 21.7 and 15.9 months (P = 0.733); mean OS of two subgroups were 41.7 and 40.9 months (P = 0.316). There were no significant differences of 1-, 2-, 3-, 4-and 5-years TTR and OS and patients' immunity pre- and 1 month post-treatment. Extrahepatic metastasis was found to have a statistically significant influence on TTR, and AFP, extrahepatic metastasis were found to have a statistically significant influence on OS by multivariate analysis. There was no major complications and procedure related death. Iodine-125 brachytherapy prophylaxis after RFA can't improve TTR and OS of HCC patients who were in high risk of locoregional tumor recurrence.
本研究评估了射频消融 (RFA) 后碘-125 近距离放疗预防是否能延长局部复发高危肝癌患者的无复发生存时间 (TTR) 和总生存时间 (OS)。116 例 RFA 后肿瘤完全坏死的患者分为碘-125 近距离放疗预防治疗组和对照组。主要终点是 TTR,次要终点是 OS 和与治疗相关的不良事件。两组患者的基线特征无显著差异。每位患者的平均碘-125 粒子数为 29.8(26.59±12.51mCi)。平均随访时间为 25 个月,治疗组和对照组的平均 TTR 分别为 21.7 和 15.9 个月(P=0.733);两组的平均 OS 分别为 41.7 和 40.9 个月(P=0.316)。1、2、3、4 和 5 年 TTR 和 OS 以及治疗前后患者免疫功能无显著差异。多因素分析显示,肝外转移对 TTR 有统计学意义的影响,AFP、肝外转移对 OS 有统计学意义的影响。无严重并发症和与治疗相关的死亡。RFA 后碘-125 近距离放疗预防不能提高局部复发高危肝癌患者的 TTR 和 OS。