CT-Guided (125)I Brachytherapy in the Treatment of Hepatocellular Carcinoma Refractory to Conventional Transarterial Chemoembolization: A Pilot Study

PURPOSE: To investigate the efficacy and safety of CT-guided (125)I brachytherapy in the treatment of hepatocellular carcinoma (HCC) refractory to conventional transarterial chemoembolization (TACE). METHODS: Nineteen patients with TACE-refractory HCC treated with CT-guided (125)I brachytherapy between June 2017 and June 2020 at Jiangyin People’s Hospital were enrolled in this study. In addition, we used the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria to evaluate the treatment response after (125)I brachytherapy. RESULTS: Twenty-one tumours were treated with CT-guided (125)I brachytherapy in nineteen patients. Twelve tumours (57.1%) showed a complete response, and a partial response was observed in seven tumours (33.3%). The six-month objective response rate was 90.5% (19/21). The adverse effects of CT-guided (125)I brachytherapy were tolerable. CONCLUSION: Our preliminary clinical experience demonstrated that CT-guided (125)I brachytherapy was effective and well tolerated for the treatment of TACE-refractory HCC, suggesting that CT-guided (125)I brachytherapy has the potential to become an effective alternative treatment for TACE-refractory HCC.