Meng P, Ma JP, Huang XF, Zhang KL. Application of radioactive iodine-125 microparticles in hepatocellular carcinoma with portal vein embolus. World J Gastrointest Surg 2024; 16(7): 2023-2030 [PMID: 39087134 DOI: 10.4240/wjgs.v16.i7.2023]
Corresponding Author of This Article
Kang-Le Zhang, Doctor, The Third Department of Oncology, Yantai Hospital of Traditional Chinese Medicine, No. 39 Xingfu Road, Zhifu District, Yantai 264001, Shandong Province, China. zhangkangle1987@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Peng Meng, The Fourth Department of Oncology, Yantai Hospital of Traditional Chinese Medicine, Yantai 264001, Shandong Province, China
Ji-Peng Ma, Department of Medical Services, Yantai Hospital of Traditional Chinese Medicine, Yantai 264001, Shandong Province, China
Xiao-Fei Huang, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510062, Guangdong Province, China
Kang-Le Zhang, The Third Department of Oncology, Yantai Hospital of Traditional Chinese Medicine, Yantai 264001, Shandong Province, China
Co-first authors: Peng Meng and Ji-Peng Ma.
Author contributions: Meng P and Ma JP wrote the manuscript and contributed equally to this work; Huang XF collected the data; Zhang KL guided the study; All authors reviewed, edited, and approved the final manuscript and revised it critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Institutional review board statement: This study was approved by the Medical Research Ethics Committee of The First Affiliated Hospital of Sun Yat-sen University.
Informed consent statement: This study has obtained the informed consent of the patients and their families who signed the informed consent for treatment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: Statistical analysis plan, informed consent form, and clinical study report will also be shared if requested. E-mail: zhangkangle1987@163.com.
STROBE statement: This study complied with STROBE statement, ensuring transparency and accuracy in study design, data analysis and reporting of results.
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: Kang-Le Zhang, Doctor, The Third Department of Oncology, Yantai Hospital of Traditional Chinese Medicine, No. 39 Xingfu Road, Zhifu District, Yantai 264001, Shandong Province, China. zhangkangle1987@163.com
Received: May 2, 2024 Revised: May 22, 2024 Accepted: June 13, 2024 Published online: July 27, 2024 Processing time: 80 Days and 21.5 Hours
Abstract
BACKGROUND
Radioactive iodine-125 (125I) 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. 125I 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 125I particles in portal vein embolization patients with hepatocellular carcinoma in order to provide more powerful evidence supporting clinical treatment.
AIM
To investigate the effect of transcatheter arterial chemoembolization combined with portal vein 125I particle implantation in the treatment of primary liver cancer patients with portal vein tumor thrombus and its influence on liver function.
METHODS
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 125I 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 t test was used to compare the measurement data between the two groups, and the χ2 test was used to compare the counting data between groups.
RESULTS
The tumor lesion response rate in the combination group (59.62% vs 38.64%) and the response rate of patients with primary liver cancer complicated with portal vein tumor thrombus (80.77% vs 59.09%) were significantly greater than those in the control group (χ2 = 4.196, 5.421; P = 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 (t = 3.891, 3.291, 2.330, 3.729, 3.582, 4.126; P < 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 (P < 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 (P < 0.05).
CONCLUSION
In patients with primary liver cancer and a thrombus in the portal vein, transcatheter arterial chemoembolization plus portal vein 125I 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.
Core Tip: This study investigated the clinical value of radioactive iodine-125 (125I) particles in the treatment of hepatocellular carcinoma with portal vein embolism. The study reviewed data from patients who received 125I microparticle implantation to evaluate its effect on tumor control and survival. At the same time, monitoring treatment-related safety and complications provided a basis for evaluating the efficacy and risk of 125I particles in this pathological scenario.
