Transarterial chemoembolization with 125I seed insertion for multifocal hepatocellular carcinoma

You-Bin Wang; Ying Zhang; Peng-Fei Li; Le Bao; Wen-Tao Zhang

doi:10.3389/fonc.2024.1384293

Transarterial chemoembolization with ¹²⁵I seed insertion for multifocal hepatocellular carcinoma

Front Oncol. 2024 Apr 15:14:1384293. doi: 10.3389/fonc.2024.1384293. eCollection 2024.

Authors

You-Bin Wang^#¹, Ying Zhang^#², Peng-Fei Li^#¹, Le Bao¹, Wen-Tao Zhang³

Affiliations

¹ Department of Interventional Radiology, Xuzhou Cancer Hospital, Xuzhou, China.
² Department of Radiology, Xuzhou Central Hospital, Xuzhou, China.
³ Department of Gastrointestinal Surgery, Xuzhou Central Hospital, Xuzhou, China.

^# Contributed equally.

Abstract

Background: A common treatment strategy for individuals with multifocal hepatocellular carcinoma (HCC) who are not candidates for surgical resection is transarterial chemoembolization (TACE). Combining TACE with ¹²⁵I seed insertion (ISI) may offer a means of enhancing therapeutic efficacy. The purpose of this study was to compare the therapeutic efficacy of TACE administered with and without ISI for the treatment of multifocal HCC.

Methods: The data from the two centers were analyzed retrospectively. The present study involved 85 consecutive patients with multifocal HCC who underwent TACE between January 2018 and December 2021. Of these patients, 43 were in the combined group, receiving TACE with ISI, and 42 were in the TACE-only group, receiving TACE without ISI. Comparisons of treatment outcomes were made between these groups.

Results: No significant differences in baseline data were observed between these groups of patients. Higher rates of complete (60.5% vs. 33.3%, P = 0.016) and total (93.0% vs. 61.9%, P = 0.001) responses were evident in the combined group compared to the TACE-only group. Median progression-free survival (PFS, 13 vs. 10 months, P = 0.014) and overall survival (OS, 22 vs. 17 months, P = 0.035) were also significantly longer in the combined group than in the TACE-only group. Using a Cox regression analysis, risk variables associated with shorter PFS and OS included Child-Pugh B status (P = 0.027 and 0.004) and only TACE treatment (P = 0.011 and 0.022).

Conclusion: In summary, these findings suggest that, as compared to TACE alone, combining TACE and ISI can enhance HCC patients' treatment outcomes and survival.

Keywords: 125I seed; TACE; hepatocellular carcinoma; multifocal; survival.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by Xuzhou City Important Development Program (KC22150).