血管内近程放疗联合支架植入及经动脉化疗栓塞治疗肝细胞肝癌合并门脉主干癌栓

Objective To evaluate the safety and efficacy of endovascular implantation of iondine-125 (125I) seeds strand and stent combined with transarterial chemoembolization (TACE) to treat hepatocellular carcinoma (HCC) with main portal vein (MPV) tumor thrombus (MPVTT).Methods Data on treatment with intra-portal vein stent placement and TACE in 289 consecutive HCC patients with MPVTT,from Jan., 2009 to Dec., 2014 in Zhongshan Hospital of Fudan University were analyzed retrospectively.Synchronal implantation of 125I seeds strand in MPV was performed in 194 patients (study group).The remaining 95 patients who refused endovascular brachytherapy served as control (control group).The overall survival,free of disease progression survival,stent patency period and procedure-related adverse events were compared between the two groups.Results All 125I seeds strand and stent were implanted in obstructed MPV correctly without serious procedure-related adverse events.During a mean of (10.1±5.2) months’ follow-up,the median survival was (9.3±1.1) months in study group,while it was (4.9±0.5) months in control group,respectively (P<0.001).Median free of disease progression survival in study and control group was (6.0±0.3) months and (3.0±0.1) months (P<0.001).Median stent patency period was (11.0±1.1) months in study group and (4.8±0.3) months in control group,respectively (P<0.001).Conclusions These findings suggested that endovascular implantation of 125I seeds strand and stent combined with TACE was potentially a safe and effective treatment option for patients with HCC and MPVTT.