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2024 ; 16
(7
): 2023-2030
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Application of radioactive iodine-125 microparticles in hepatocellular carcinoma
with portal vein embolus
#MMPMID39087134
Meng P
; Ma JP
; Huang XF
; Zhang KL
World J Gastrointest Surg
2024[Jul]; 16
(7
): 2023-2030
PMID39087134
show ga
BACKGROUND: Radioactive iodine-125 ((125)I) 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. (125)I 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 (125)I 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 (125)I
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 (125)I 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 ? (2) 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 (? (2) =
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 (125)I
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.