Efficacy of 125 I seed implantation as an adjunctive therapy for extrahepatic metastasis of primary hepatocellular carcinoma

Abstract

Objective To evaluate the efficacy of 125Ⅰ seed implantation for extra-hepatic metastasis of primary hepatocellular carcinoma (HCC) treatment. Methods The clinical records of 26 patients with primary HCC and extrahepatic metastasis were reviewed. Twenty six patients had 31 primary hepatic lesions, 14 patients had 32 lung metastasis, 6 had 8 bone metastasis and 6 had 8 hepatohilar or retroperitoneal lymphatic metastasis. The hepatic lesions were heated by combination of transcatheter arterial chemo-embolization(TACE) and radiofrequency ablation(RFA) or percutaneous ethanol injection (PEI) and were followed up by contrast-enhanced CT (CECT) after 1 month. The extra-hepatic lesions were treated by 125Ⅰ seeds implantation and were followed up by CECT 3 months after treatment. The treatments were evaluated by imaging examinations. The patients were followed up every 1 month during the first half year, including CT examinations of chest, abdomen and lesions and chest films. Telephone follow-up were pedormed every 3 months after the 6th month till they were lost and the survival time were calculated. Results Of the extra-hepatic lesions, 16 cases were complete response (CR), 3 cases were partial response (PR), 4 cases were stable disease (SD) and 3 were progressive diseases(PD). Of the hepatic lesions, 11 were CR, 4 were PR, 6 were SD and 5 PD. The 26 patients are survived at the time of end of follow-up (7. 0 to 24. 0 months). The median survival duration was 14. 5 months. Conclusions 125Ⅰ seed implantation integrated interventional and minimally invasive therapy could improve the life and survival and it is an effective adjunctive therapy for primary hepatocellular carcinoma with metastasis outside the liver. Key words: Liver neoplasm; Neoplasm metastasis; Radiolngy; interventional