| Objective:To explore evaluate the feasibility, safety and efficacy of using transcatheter arterial chemoembolization (TACE) combined with125I seed brachytherapy on unresectable hepatocellular carcinoma (HCC).Methods:From Feb.2008to Feb.2010,69consecutive patients who had unresectable HCC were enrolled in this retrospective study.60cases were male and9females, age28-80years,(mean59.6years), all patients with pathologically diagnosed as hepatocellular carcinoma (HCC).29patients had2lesions,8patients had3lesions, total lesions114, diameter3-7cm, no extrahepatic metastasis.12cases were AJCC stage II,41cases were Ⅱb,16cases wereⅢa,47cases were Child-Pugh A,22cases were Child-Pugh B. These patients were assigned to receive sequential therapy by TACE, CT scan was given after48to96hours, followed by CT-guided interstitial125I seed implantation according to the Treatment Plan System (TPS). The local efficacy was evaluated according to the RECIST criteria; the6months,12months,24months survival was evaluated by Kaplan-Meier survival analysis.Results:125I seeds were implanted in place according to the TPS, mean39.8lodine-125seeds were implanted and no seed was lost in the process. No serious complications of infection, bleeding, gastrointestinal perforation were found in intraoperative and postoperative. Local efficient (CR+PR) was 79.7%.AII patients with a median progression-free survival was10months (95%CI,5.77-14.23months), those of patients6,12and24months progression-free survival rates were73.6%(95%CI,63.2-84.1%),47.1%(95%CI,34.659.6%),23.7%(95%CI,11.3-36.1%). The1,2years cumulative survival rate were85.3%(95%CI,76.9-93.7%),48.7%(95%CI,35.7.9-61.6%).Conclusions:The CT guided125I seeds seed implantation combined with TACE of HCC was safe and effective, which improves local control rate and provides a simple and safe minimally invasive treatment options for unresectable HCC. |
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