Meng Peng, Ma Ji-Peng, Huang Xiao-Fei, Zhang Kang-Le
The Fourth Department of Oncology, Yantai Hospital of Traditional Chinese Medicine, Yantai 264001, Shandong Province, China.
Department of Medical Services, Yantai Hospital of Traditional Chinese Medicine, Yantai 264001, Shandong Province, China.
World J Gastrointest Surg. 2024 Jul 27;16(7):2023-2030. doi: 10.4240/wjgs.v16.i7.2023.
Radioactive iodine-125 (I) microparticle therapy is a new type of internal radiation therapy that has shown unique advantages in the treatment of malignant tumors, especially hepatocellular carcinoma. Patients with hepatocellular carcinoma frequently experience portal vein embolism, which exacerbates the difficulty and complexity of treatment. I particles, used in local radiotherapy, can directly act on tumor tissue and reduce damage to surrounding healthy tissue. Through retrospective analysis, this study discussed the efficacy and safety of radioactive I particles in portal vein embolization patients with hepatocellular carcinoma in order to provide more powerful evidence supporting clinical treatment.
To investigate the effect of transcatheter arterial chemoembolization combined with portal vein I particle implantation in the treatment of primary liver cancer patients with portal vein tumor thrombus and its influence on liver function.
The clinical data of 96 patients with primary liver cancer combined with portal vein tumor thrombus admitted to our hospital between January 2020 and December 2023 were retrospectively analyzed. Fifty-two patients received treatment with transcatheter arterial chemoembolization and implantation of I particles in the portal vein (combination group), while 44 patients received treatment with transcatheter arterial chemoembolization alone (control group). The therapeutic effects on tumor lesions, primary liver cancer, and portal vein tumor embolisms were compared between the two groups. Changes in relevant laboratory indexes before and after treatment were evaluated. The test was used to compare the measurement data between the two groups, and the test was used to compare the counting data between groups.
The tumor lesion response rate in the combination group (59.62% 38.64%) and the response rate of patients with primary liver cancer complicated with portal vein tumor thrombus (80.77% 59.09%) were significantly greater than those in the control group ( = 4.196, 5.421; = 0.041, 0.020). At 8 wk after surgery, the serum alpha-fetoprotein, portal vein main diameter, and platelet of the combined group were significantly lower than those of the control group, and the serum alanine aminotransferase, aspartate aminotransferase, and total bilirubin were significantly greater than those of the control group ( = 3.891, 3.291, 2.330, 3.729, 3.582, 4.126; < 0.05). The serum aspartate aminotransferase, alanine aminotransferase, and total bilirubin levels of the two groups were significantly greater than those of the same group 8 wk after surgery ( < 0.05), and the peripheral blood platelet, alpha-fetoprotein, and main portal vein diameter were significantly less than those of the same group before surgery ( < 0.05).
In patients with primary liver cancer and a thrombus in the portal vein, transcatheter arterial chemoembolization plus portal vein I implantation is more effective than transcatheter arterial chemoembolization alone. However, during treatment it is crucial to pay attention to liver function injury caused by transcatheter arterial chemoembolization.
放射性碘-125（I）微粒治疗是一种新型内放射治疗方法，在恶性肿瘤尤其是肝细胞癌的治疗中显示出独特优势。肝细胞癌患者常发生门静脉栓塞，这加剧了治疗的难度和复杂性。用于局部放疗的I粒子可直接作用于肿瘤组织，并减少对周围健康组织的损伤。通过回顾性分析，本研究探讨放射性I粒子在门静脉栓塞的肝细胞癌患者中的疗效和安全性，以便为临床治疗提供更有力的证据支持。
探讨经导管动脉化疗栓塞术联合门静脉I粒子植入术治疗原发性肝癌合并门静脉癌栓患者的效果及其对肝功能的影响。
回顾性分析2020年1月至2023年12月我院收治的96例原发性肝癌合并门静脉癌栓患者的临床资料。52例患者接受经导管动脉化疗栓塞术联合门静脉I粒子植入治疗（联合组），44例患者仅接受经导管动脉化疗栓塞术治疗（对照组）。比较两组对肿瘤病灶、原发性肝癌和门静脉肿瘤栓塞的治疗效果。评估治疗前后相关实验室指标的变化。采用 检验比较两组间的计量资料，采用 检验比较组间的计数资料。
联合组的肿瘤病灶缓解率（59.62% 38.64%）和原发性肝癌合并门静脉癌栓患者的缓解率（80.77% 59.09%）显著高于对照组（ = 4.196，5.421； = 0.041，0.020）。术后8周，联合组的血清甲胎蛋白、门静脉主干直径和血小板显著低于对照组，血清丙氨酸氨基转移酶、天冬氨酸氨基转移酶和总胆红素显著高于对照组（ = 3.891，3.291，2.330，3.729，3.582，4.126； < 0.05）。两组的血清天冬氨酸氨基转移酶、丙氨酸氨基转移酶和总胆红素水平均显著高于术后8周时的同组水平（ < 0.05），外周血血小板、甲胎蛋白和门静脉主干直径显著低于术前同组水平（ < 0.05）。
对于原发性肝癌合并门静脉血栓的患者，经导管动脉化疗栓塞术加门静脉I粒子植入术比单纯经导管动脉化疗栓塞术更有效。然而，治疗期间关注经导管动脉化疗栓塞术引起的肝功能损伤至关重要。
