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CT-guided 125I brachytherapy for hepatocellular carcinoma in high-risk locations after transarterial chemoembolization combined with microwave ablation: a propensity score-matched study

Zixiong Chen
Zixiong Chen
, 
Xiaobo Fu
Xiaobo Fu
, 
Zhenkang Qiu
Zhenkang Qiu
, 
Maoyuan Mu
Maoyuan Mu
, 
Weiwei Jiang
Weiwei Jiang
, 
Guisong Wang
Guisong Wang
, 
Zhihui Zhong
Zhihui Zhong
, 
Han Qi
Han Qi
 and 
Fei Gao
Fei Gao
   | Mar 22, 2023
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Article Category: Research Article
Published Online: Mar 22, 2023
Page range: 127 - 139
Received: Dec 29, 2022
Accepted: Jan 30, 2023
DOI: https://doi.org/10.2478/raon-2023-0012
© 2023 Zixiong Chen, Xiaobo Fu, Zhenkang Qiu, Maoyuan Mu, Weiwei Jiang, Guisong Wang, Zhihui Zhong, Han Qi, Fei Gao, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Background

This study aimed to evaluate the safety and efficacy of 125I brachytherapy combined with transarterial chemoembolization (TACE) and microwave ablation (MWA) for unresectable hepatocellular carcinoma (HCC) in high-risk locations.

Patients and methods

After 1:2 propensity score matching (PSM), this retrospectively study analyzed 49 patients who underwent TACE +MWA+125I brachytherapy (group A) and 98 patients who only received TACE +MWA (group B). The evaluated outcomes were progression-free survival (PFS), overall survival (OS), and treatment complications. Cox proportional hazards regression analysis survival was used to compare the two groups.

Results

The patients in group A showed a longer PFS than group B (7.9 vs. 3.3 months, P = 0.007). No significant differences were observed in median OS between the two groups (P = 0.928). The objective response rate (ORR), disease control rate of tumors in high-risk locations, and the ORR of intrahepatic tumors were 67.3%, 93.9%, and 51.0%, respectively, in group A, and 38.8%, 79.6% and 29.6%, respectively, in group B (P < 0.001, P = 0.025 and P = 0.011, respectively). TACE-MWA-125I (HR = 0.479, P < 0.001) was a significant favorable prognostic factor that affected PFS. The present of portal vein tumor thrombosis was an independent prognostic factor for PFS (HR = 1.625, P = 0.040). The Barcelona clinic liver cancer (BCLC) stage (BCLC C vs. B) was an independent factor affecting OS (HR = 1.941, P = 0.038). The incidence of complications was similar between the two groups, except that the incidence of abdominal pain was reduced in the group A (P = 0.007).

Conclusions

TACE-MWA-125I resulted in longer PFS and better tumor control than did TACE-MWA in patients with unresectable hepatocellular carcinoma in high-risk locations.
eISSN:
1581-3207
Language:
English
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Journal Subjects:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology
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