Published online Jan 27, 2023. doi: 10.4240/wjgs.v15.i1.105
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
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.
To investigate the clinical efficacy of TACE combined with radioactive iodine implantation therapy in advanced PHC via perfusion computed tomography (CT).
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.
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].
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.
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.