Yuan Qianqian, Ma Yanli, Wu Linlin, Song Yuqing, He Chuang, Huang Xuequan, Yang Chongshuang, Liu Bin, Han Hongmei, Zhang Kaixian, Wang Junjie
Department of Oncology, Tengzhou Central People's Hospital, Zaozhuang, China.
Department of Oncology, Staff Hospital of Chengde Iron and Steel Group Co. Ltd., Chengde, China.
Front Oncol. 2022 Apr 8;12:819934. doi: 10.3389/fonc.2022.819934. eCollection 2022.
The efficacy and safety of CT-Guided Iodine-125 Radioactive Seed Implantation (RSI) for the treatment of intrahepatic recurrent hepatocellular carcinoma (rHCC) were analyzed in this multicenter retrospective study. We reviewed the medical records of patients with rHCC treated with I-125 seed implantation at four different hospitals in China from December 2011 and January 2021. The local progression-free survival (LPFS),liver PFS, and overall survival (OS) were calculated, and the short-term efficacy and treatment-related toxicities were evaluated. A total of 82 patients were enrolled; the median follow-up time was 46 months (range, 3-80 months). The 1-, 3- and 5-year LPFS rates were 63.8%, 27.1%, and 7.9%, respectively, and the corresponding OS rates were 74.8%, 32.9%, and 12.6%, respectively. Univariate analysis showed that factors influencing LPFS included the maximum lesion diameter, Barcelona Clinic Liver Cancer (BCLC) stage, interval between treatment and recurrence, and D90. Multivariate analyses revealed that the BCLC stage, interval between treatment and recurrence, and D90 were independent factors influencing LPFS, whereas BCLC stage, D90, and short-term efficacy were independent factors influencing OS. In summary, I-125 seed implantation is a safe and effective treatment for rHCC. The BCLC stage, interval, and D90 were found to influence the local control. A larger, prospective study is required to confirm the dose-response curve for Iodine-125 RSI of rHCC.
在这项多中心回顾性研究中，分析了CT引导下碘-125放射性粒子植入术（RSI）治疗肝内复发性肝细胞癌（rHCC）的疗效和安全性。我们回顾了2011年12月至2021年1月在中国四家不同医院接受碘-125粒子植入治疗的rHCC患者的病历。计算局部无进展生存期（LPFS）、肝脏无进展生存期（PFS）和总生存期（OS），并评估短期疗效和治疗相关毒性。共纳入82例患者；中位随访时间为46个月（范围3 - 80个月）。1年、3年和5年的LPFS率分别为63.8%、27.1%和7.9%，相应的OS率分别为74.8%、32.9%和12.6%。单因素分析显示，影响LPFS的因素包括最大病灶直径、巴塞罗那临床肝癌（BCLC）分期、治疗与复发间隔以及D90。多因素分析显示，BCLC分期、治疗与复发间隔以及D90是影响LPFS的独立因素，而BCLC分期、D90和短期疗效是影响OS的独立因素。总之，碘-125粒子植入术是治疗rHCC的一种安全有效的方法。发现BCLC分期、间隔和D90会影响局部控制。需要开展更大规模的前瞻性研究来确定rHCC碘-125 RSI的剂量反应曲线。
