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CT-guided (125)I Brachytherapy for Hepatocellular Carcinoma in High-risk Locations after Transarterial Chemoembolization Combined with Microwave Ablation: A Propensity Score-matched Study
BACKGROUND: This study aimed to evaluate the safety and efficacy of (125)I 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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sciendo
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10039481/ https://www.ncbi.nlm.nih.gov/pubmed/36942903 http://dx.doi.org/10.2478/raon-2023-0012 |
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author | Chen, Zixiong Fu, Xiaobo Qiu, Zhenkang Mu, Maoyuan Jiang, Weiwei Wang, Guisong Zhong, Zhihui Qi, Han Gao, Fei |
author_facet | Chen, Zixiong Fu, Xiaobo Qiu, Zhenkang Mu, Maoyuan Jiang, Weiwei Wang, Guisong Zhong, Zhihui Qi, Han Gao, Fei |
author_sort | Chen, Zixiong |
collection | PubMed |
description | BACKGROUND: This study aimed to evaluate the safety and efficacy of (125)I 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+(125)I 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-(125)I (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-(125)I resulted in longer PFS and better tumor control than did TACE-MWA in patients with unresectable hepatocellular carcinoma in high-risk locations. |
format | Online Article Text |
id | pubmed-10039481 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Sciendo |
record_format | MEDLINE/PubMed |
spelling | pubmed-100394812023-03-26 CT-guided (125)I Brachytherapy for Hepatocellular Carcinoma in High-risk Locations after Transarterial Chemoembolization Combined with Microwave Ablation: A Propensity Score-matched Study Chen, Zixiong Fu, Xiaobo Qiu, Zhenkang Mu, Maoyuan Jiang, Weiwei Wang, Guisong Zhong, Zhihui Qi, Han Gao, Fei Radiol Oncol Research Article BACKGROUND: This study aimed to evaluate the safety and efficacy of (125)I 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+(125)I 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-(125)I (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-(125)I resulted in longer PFS and better tumor control than did TACE-MWA in patients with unresectable hepatocellular carcinoma in high-risk locations. Sciendo 2023-03-22 /pmc/articles/PMC10039481/ /pubmed/36942903 http://dx.doi.org/10.2478/raon-2023-0012 Text en © 2023 Zixiong Chen, Xiaobo Fu, Zhenkang Qiu, Maoyuan Mu, Weiwei Jiang, Guisong Wang, Zhihui Zhong, Han Qi, Fei Gao, published by Sciendo https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. |
spellingShingle | Research Article Chen, Zixiong Fu, Xiaobo Qiu, Zhenkang Mu, Maoyuan Jiang, Weiwei Wang, Guisong Zhong, Zhihui Qi, Han Gao, Fei CT-guided (125)I Brachytherapy for Hepatocellular Carcinoma in High-risk Locations after Transarterial Chemoembolization Combined with Microwave Ablation: A Propensity Score-matched Study |
title | CT-guided (125)I Brachytherapy for Hepatocellular Carcinoma in High-risk Locations after Transarterial Chemoembolization Combined with Microwave Ablation: A Propensity Score-matched Study |
title_full | CT-guided (125)I Brachytherapy for Hepatocellular Carcinoma in High-risk Locations after Transarterial Chemoembolization Combined with Microwave Ablation: A Propensity Score-matched Study |
title_fullStr | CT-guided (125)I Brachytherapy for Hepatocellular Carcinoma in High-risk Locations after Transarterial Chemoembolization Combined with Microwave Ablation: A Propensity Score-matched Study |
title_full_unstemmed | CT-guided (125)I Brachytherapy for Hepatocellular Carcinoma in High-risk Locations after Transarterial Chemoembolization Combined with Microwave Ablation: A Propensity Score-matched Study |
title_short | CT-guided (125)I Brachytherapy for Hepatocellular Carcinoma in High-risk Locations after Transarterial Chemoembolization Combined with Microwave Ablation: A Propensity Score-matched Study |
title_sort | ct-guided (125)i brachytherapy for hepatocellular carcinoma in high-risk locations after transarterial chemoembolization combined with microwave ablation: a propensity score-matched study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10039481/ https://www.ncbi.nlm.nih.gov/pubmed/36942903 http://dx.doi.org/10.2478/raon-2023-0012 |
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