Research Papers:
Endovascular brachytherapy combined with portal vein stenting and transarterial chemoembolization improves overall survival of hepatocellular carcinoma patients with main portal vein tumor thrombus
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Abstract
Tian-Zhu Yu1,2,*, Wen Zhang1,2,*, Qing-Xin Liu1,2,*, Wen-Hui Li4,*, Jing-Qin Ma1,2, Zi-Han Zhang1,2, Min-Jie Yang1,2, Jian-Hua Wang1,2, Bing Chen3, Shao-Chong Zeng3, Jian-Jun Luo1,2, Ling-Xiao Liu1,2, Zhi-Ping Yan1,2
1Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
2Shanghai Institute of Medical Imaging, Shanghai, China
3Department of Radiotherapy, Zhongshan Hospital, Fudan University, Shanghai, China
4Department of Interventional Radiology, Yancheng Third People’s Hospital, Southeast University, Yancheng, China
*These authors have contributed equally to this work
Correspondence to:
Jian-Jun Luo, email: [email protected]
Ling-Xiao Liu, email: [email protected]
Zhi-Ping Yan, email: [email protected]
Keywords: hepatocellular carcinoma, main portal vein, tumor thrombus, endovascular brachytherapy, three-dimensional conformal radiotherapy
Received: October 20, 2016 Accepted: December 27, 2016 Published: January 05, 2017
ABSTRACT
Hepatocellular carcinoma (HCC) patients with main portal vein tumor thrombus have a median survival time of only about 4 months. We therefore compared the safety and efficacy of endovascular brachytherapy (EVBT) and sequential three-dimensional conformal radiotherapy (3-DCRT). From a cohort of 176 patients, we treated 123 with EVBT using iodine-125 seed strands (group A) and the remaining 53 with sequential 3-DCRT (group B). Overall survival, progression free survival and stent patency characteristics were compared between the two groups. Our analysis demonstrated a median survival of 11.7 ± 1.2 months in group A versus 9.5 ± 1.8 months in group B (p = 0.002). The median progression free survival was 5.3 ± 0.7 months in groupA versus 4.4 ± 0.4 months in group B (p = 0.010). The median stent patency period was 10.3 ± 1.1 months in group A versus 8.7 ± 0.7 months in group B (p = 0.003). Therefore, as compared to sequential 3-DCRT, EVBT combined with portal vein stenting and TACE improved overall survival of HCC patients with main portal vein tumor thrombus.
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