Department of Radiology, Lishui Central Hospital/Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang Province, Lishui, China.
Cancer Biother Radiopharm. 2021 Dec;36(10):820-826. doi: 10.1089/cbr.2020.3647. Epub 2020 Jun 16.
Radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC) is limited by locoregional recurrence and/or residual tumors caused by incomplete ablation. Iodine-125 (I) brachytherapy can achieve a high local control rate in solid carcinoma, but few studies have assessed the efficacy of this treatment for locoregional recurrence and/or residual HCC after RFA. To investigate the effectiveness and safety of I brachytherapy for treating locoregional recurrence and/or residual HCC in patients treated with RFA. Eligible study patients were those with locoregional recurrence and/or residual HCC on abdominal imaging performed 1 month after RFA at this institution between February 2009 and September 2014 retrospectively. Patients were divided into either the control group (no treatment until the tumor progressed) or the treatment group (underwent I brachytherapy). Progression-free survival (PFS), overall survival (OS), and complications of I brachytherapy were evaluated. A total of 42 patients were included in the final analysis, including 29 in the control group and 13 in the treatment group. A total of 457 I particles were used (mean 32.8 ± 21.3 mCi per case). The median follow-up time was 25 months. Median PFS was 9 months in the control group and 18 months in the treatment group ( = 0.026). The median OS was 28 months in the control group and 33 months in the treatment group ( = 0.441). There were no major complications observed in patients treated with I brachytherapy. Iodine-125 brachytherapy can prolong PFS in patients with locoregional recurrence and/or residual HCC after RFA.
射频消融 (RFA) 治疗肝细胞癌 (HCC) 的局限性在于局部复发和/或消融不完全导致的残留肿瘤。碘-125（I）近距离放疗在实体癌中可获得较高的局部控制率，但很少有研究评估其对 RFA 后局部复发和/或残留 HCC 的疗效。 旨在探讨 I 近距离放疗治疗 RFA 后局部复发和/或残留 HCC 的有效性和安全性。 符合条件的研究患者为 2009 年 2 月至 2014 年 9 月在该机构接受 RFA 治疗后 1 个月腹部影像学检查发现局部复发和/或残留 HCC 的患者。患者分为对照组（肿瘤进展前无治疗）或治疗组（接受 I 近距离放疗）。评估无进展生存期（PFS）、总生存期（OS）和 I 近距离放疗的并发症。 最终分析共纳入 42 例患者，其中对照组 29 例，治疗组 13 例。共使用 457 粒 I 粒子（平均每例 32.8±21.3 mCi）。中位随访时间为 25 个月。对照组的中位 PFS 为 9 个月，治疗组为 18 个月（=0.026）。对照组的中位 OS 为 28 个月，治疗组为 33 个月（=0.441）。接受 I 近距离放疗的患者无重大并发症。 I 近距离放疗可延长 RFA 后局部复发和/或残留 HCC 患者的 PFS。
