Ultrasound-guided radioactive seed implantation for treatment of recurrent hepatocellular carcinoma

Abstract

Objective To evaluate the efficacy of ultrasound-guided radioactive seed implantation in the treatment of recurrent hepatocellular carcinoma. Methods Image reconstruction was performed in 31 patients with recurrent hepatocellular carcinoma. Preoperative planning was carried out by using the treatment planning system (TPS). Particles were placed according to the plan under the guidance of real-time ultrasound during operation. Postoperative enhanced imaging reconstruction was performed, and radiodosimetric evaluation and curative effect evaluation were carried out using the TPS. The indicators evaluated included imaging changes at 3, 6 and 12 months after operation, postoperative complications, local tumor control rate, progression-free survival (PFS), and overall survival (OS). SPSS 19.0 software was used for statistical analyses, and Kaplan Meier method was used to plot the survival curve. Results All operations were successfully completed. The median follow-up time was 25 months. The complete remission rate, partial remission rate, disease stability rate, and local control rate were 3% (1/33), 15.2% (5/33), 75.8% (25/33), and 93.9 (31/33), respectively, and two (6.1%, 2/33) cases had local progress. The local control rate was 90.9% (30/33) at 12 months after operation. The overall survival rates were 91%, 81%, and 50%, respectively, at 1, 3, and 5 years after operation. The average progression-free survival time was 27.6 months and the median progression-free survival time was 23.2 months. Postoperative pain occurred in five cases, fever in two cases, and diarrhea in one case. Conclusion Ultrasound-guided radioactive particle therapy for recurrent hepatocellular carcinoma is effective and safe. Key words: Recurrent hepatocellular carcinoma; Radiotherapy; 125I particles; Clinical efficacy