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, registration number ChiCTR-DDC-16009986 (
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:
Corresponding author: Jian Dong, MD, Doctor, Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, No. 10 Tieyi Street, Haidian District, Beijing 100038, China.
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
Research background

Primary hepatocellular carcinoma (PHC) is a malignant tumor with a high incidence in the Chinese population. Transarterial chemoembolization (TACE) is an effective treatment for PHC. Radioactive iodine (125I) therapy has been used in the treatment of advanced PHC, especially in patients with portal vein tumor thrombosis.

Research motivation

Due to insidious onset and atypical early symptoms of PHC, more than 80% of hepatocellular carcinoma patients are diagnosed with metastasis and are ineligible for surgical treatment. Therefore, it is crucial to develop effective treatment methods, such as TACE and 125I therapy. However, the data on the therapeutic effect of TACE combined with 125I therapy in PHC is scarce.

Research objectives

To investigate the short-term efficacy of TACE combined with 125I in patients with PHC.

Research methods

Ninety-eight patients with PHC were recruited and randomly divided into the study group (n = 49, treatment with TACE and 125I therapy) and the control group (n = 49, treatment with TACE alone). The tumor length, alpha-fetoprotein (AFP) level, and computed tomography (CT) perfusion were recorded. Complete remission, partial remission (PR), stable disease and progressive disease were evaluated for all patients. Then, the efficacy was compared between the control group and the study group.

Research results

The tumor length and serum AFP level were lower in the study group compared to those in the control group after 1 mo and 3 mo of therapy. After 3 mo of treatment, the complete and PR rate in the study group was higher than in the control group (93.88% vs 77.55%, P < 0.05). Furthermore, CT perfusion parameters, including blood volume, permeability surface, blood flow, hepatic artery flow, and mean transit time, were all lower in the study group than in the control group (P < 0.05). The survival time of patients in the study group was 22 mo, which was significantly longer than 18 mo in the control group [log rank (Mantel-Cox) = 4.318, P = 0.038].

Research conclusions

For advanced PHC patients, TACE combined with 125I implantation better inhibits the formation of blood vessels in tumor tissues and further reduces the perfusion level of tumor lesions compared to TACE alone. The combination of TACE and 125I therapy improves clinical efficacy and plays a synergistic role in prolonging the survival time of patients.

Research perspectives

TACE combined with 125I implantation or other therapeutic methods, such as radiofrequency ablation, programmed cell death ligand 1 therapy, and immune therapy, should be investigated in advanced PHC patients in the future.