Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
J Int Med Res. 2020 Oct;48(10):300060520944309. doi: 10.1177/0300060520944309.
To determine if iodine-125 seed implantation improved the efficacy of transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) (≤5 cm).
We retrospectively reviewed the medical records of 83 consecutive patients with HCC (≤5 cm) who underwent TACE or TACE-iodine-125 from January 2014 to July 2017. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall survival (OS) and objective response rate (ORR) at 3 months after the first TACE treatment. PFS and OS were calculated using the Kaplan-Meier method and compared using log-rank tests. Independent risk factors for PFS and OS were analyzed using a Cox proportional hazards model.
Thirty-five patients received TACE-iodine-125 and 48 received TACE alone. The median OS and PFS were both significantly longer in the TACE-iodine-125 compared with the TACE-alone group (42 vs 23 months and 16 vs 8 months, respectively). The ORR was significantly higher in the TACE-iodine-125 compared with the TACE-alone group. There was no significant difference in adverse events, apart from decreased white cell count, between the two groups.
TACE-iodine-125 might be an effective and safe alternative treatment for patients with HCC (≤5 cm).
评估碘 125 粒子植入是否能提高小肝癌（≤5cm）患者经肝动脉化疗栓塞（TACE）的疗效。
我们回顾性分析了 2014 年 1 月至 2017 年 7 月间 83 例接受 TACE 或 TACE-碘 125 治疗的小肝癌患者的病历资料。主要终点为无进展生存期（PFS）。次要终点为 TACE 治疗后 3 个月的总生存期（OS）和客观缓解率（ORR）。PFS 和 OS 采用 Kaplan-Meier 法计算，并采用对数秩检验进行比较。采用 Cox 比例风险模型分析 PFS 和 OS 的独立危险因素。
35 例患者接受 TACE-碘 125 治疗，48 例患者接受单纯 TACE 治疗。TACE-碘 125 组的中位 OS 和 PFS 均显著长于 TACE 组（42 个月 vs. 23 个月和 16 个月 vs. 8 个月）。TACE-碘 125 组的 ORR 显著高于 TACE 组。两组之间除白细胞计数减少外，不良反应无显著差异。
TACE-碘 125 可能是治疗小肝癌（≤5cm）患者的一种有效且安全的替代治疗方法。
