CT-Guided 125iodine Seed Implantation for Portal Vein Tumor Thrombus in Primary Hepatocellular Carcinoma
【摘要】：正Background To investigate the clinical value of CT guided 125iodine seed implantation in treating portal vein tumor thrombus in primary hepatocellular carcinoma patients. Methods 10 patients(9 males and 1 females,median age 51 years,range from 36 to 72) with portal vein tumor thrombus with hepatocellular carcinoma accepted CT guided 125iodine seed implantation were enrolled in this study. The portal vein tumor thrombus were not well controlled by hepatocellular carcinoma combined therapy,such as surgery,transcatheter arterial chemoembolization(TACE),radiotherapy ablation(RFA),microwave ablation(MA),or percutaneous ethanol injection(PEI).The average diameter of each tumor thrombus was 2.1×2.8cm.Under the guidance of CT,125I seeds of 0.8mCi were implanted under local anesthesia at a distance of 0.5cm along portal vein tumor thrombus according to TPS.Enhanced spiral CT follow-up was performed 4 months post intervention. Results A total of 10 patients with portal vein tumor thrombus received CT-guided 125iodine seed implantation. The local control of the treated lesions was quite satisfactory with 4 months,and the overall response rate was 90.0% (9/10),with observed complete response(CR) in 4 patients,partial response(PR) in 5 patients,and stable disease (SD) in 1 patient.The adverse effects mainly included aggravated abdominal dropsy and temporary increased hepatic aminopherase,which were controlled by medical management.Moreover,we have seen seeds migration to lung and left hepatic lobe in 1 case.No other complications such as hemorrhoea,cholo-fistulase,hepatic abscess,pancreatic fistula and hepatic function failure were encountered in all patients. Conclusions CT-guided 125iodine seed implantation was proved safety and effectiveness in the treatment of portal vein tumor thrombus with hepatocellular carcinoma with minimal damage and few complications.