Clinical Trials Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2023; 15(1): 105-113
Published online Jan 27, 2023. doi: 10.4240/wjgs.v15.i1.105
Short-term efficacy assessment of transarterial chemoembolization combined with radioactive iodine therapy in primary hepatocellular carcinoma
Lei Wang, Kun Huang, Yu Zhang, Yi-Fan Wu, Zhen-Dong Yue, Zhen-Hua Fan, Fu-Quan Liu, Yong-Wu Li, Jian Dong
Lei Wang, Yu Zhang, Yi-Fan Wu, Zhen-Dong Yue, Zhen-Hua Fan, Fu-Quan Liu, Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Kun Huang, Department of Radiology, Chinese Medical University Affiliated First Hospital, Shenyang 110001, Liaoning Province, China
Yong-Wu Li, Department of Nuclear Medicine, The Fifth Center of People’s Liberation Army General Hospital, Beijing 100071, China
Jian Dong, Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Author contributions: Dong J, Liu FQ and Wang L designed the report; Zhang Y, Wu YF, Yue ZD, Fan ZH, Huang K and Li YW collected the clinical data; Wang L, Huang K, Li YW and Zhang Y analyzed the data and wrote the paper; Huang K, Li YW, Dong J and Liu FQ performed quality control; Liu FQ contributed to administrative and financial support; and all authors read and approved the final version of the manuscript.
Supported by the National Natural Science Foundation of China General Program, No. 81871461.
Institutional review board statement: This study was approved by the Ethics Committee of the Beijing Shijitan Hospital, Capital Medical University, No. 201801.
Clinical trial registration statement: This study is registered at ClinicalTrials.gov, registration number ChiCTR-DDC-16009986 (www.chictr.org.cn/edit.aspx?pid=16996&htm=4).
Informed consent statement: Written informed consent was obtained from each patient.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Dong, MD, Doctor, Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Street, Haidian District, Beijing 100038, China. dongjianradiology@163.com
Received: November 1, 2022
Peer-review started: November 1, 2022
First decision: November 21, 2022
Revised: November 30, 2022
Accepted: December 21, 2022
Article in press: December 21, 2022
Published online: January 27, 2023
Processing time: 78 Days and 3.2 Hours
Abstract
BACKGROUND

Transarterial chemoembolization (TACE) is an effective treatment for primary hepatocellular carcinoma (PHC). Radioactive iodine therapy has been used in the treatment of advanced PHC, especially in patients with portal vein tumor thrombosis. However, data on the therapeutic effect of TACE combined with radioactive iodine therapy in PHC are scarce.

AIM

To investigate the clinical efficacy of TACE combined with radioactive iodine implantation therapy in advanced PHC via perfusion computed tomography (CT).

METHODS

For this study, 98 advanced PHC patients were recruited and divided randomly into the study and control groups. Patients in the study group were treated with TACE combined radioactive iodine implantation therapy. Patients in the control group were treated with only TACE. The tumor lesion length, clinical effect, serum alpha-fetoprotein (AFP) and CT perfusion parameters were compared before and after therapy, and statistical analysis was performed.

RESULTS

There was no significant difference in tumor length and serum AFP between the study and control groups (P > 0.05) before treatment. However, the tumor length and serum AFP in the study group were lower than those in the control group 1 mo and 3 mo after therapy. After 3 mo of treatment, the complete and partial remission rate of the study group was 93.88%, which was significantly higher than the control group (77.55%) (P < 0.05). Before treatment, there were no significant differences between the two groups on the perfusion CT variables, including the lesion blood volume, permeability surface, blood flow, hepatic artery flow and mean transit time (P > 0.05). After 3 mo of treatment, all perfusion CT variables were lower in the study group compared to the control group (P < 0.05). The survival time of patients in the study group was 22 mo compared to 18 mo in the control group, which was significantly different [log rank (Mantel-Cox) = 4.318, P = 0.038].

CONCLUSION

TACE combined with radioactive iodine implantation in the treatment of advanced PHC can inhibit the formation of blood vessels in tumor tissue and reduce the perfusion level of tumor lesions, thereby improving the clinical efficacy and prolonging the survival time of patients.

Keywords: Transarterial chemoembolization; Radioactive iodine; Primary hepatocellular carcinoma; Perfusion; Computed tomography

Core Tip: This randomized controlled trial was designed to investigate the short-term clinical efficacy of transarterial chemoembolization (TACE) combined with radioactive iodine implantation in the treatment of patients with primary hepatocellular carcinoma (PHC). The results demonstrated that this treatment could inhibit the formation of blood vessels in tumor tissue and reduce the perfusion level of tumor lesions better than TACE alone. Therefore, TACE combined with radioactive ion implantation could improve the clinical efficacy and prolong the survival time of patients with PHC.