Observation Of Portal Vein ¹²⁵Iodine Implantation To Prevent Digestive Tract Bleeding In Patients With Portal Vein Tumor Thrombus In Primary Hepatocellular Carcinoma

ObjectiveThis study was to discuss the clinical application of CT guided ¹²⁵iodine implantation in patients with portal vein tumor thrombus in primary hepatocellular carcinoma and the effect of preventing variceal bleeding.MethodsFrom October 2013 to July 2014,40 eligible patients with portal vein tumor thrombus accompanying hepatocellular carcinoma were subdivided into two groups according to the patient's wishes.Twenty patients were included in treatment group,they were treated by TACE for hepatic tumor and¹²⁵iodine seed implantation for portal vein tumor thrombus.Twenty patients were included in control group,they were treated by TACE for hepatic tumor and only took ?-blockers medicines after treatment.After 3 months later,enhanced abdominal CT scan was performed to evaluate treatment effects.Intraoperative and postoperative surgery-related complications were observed.The bleeding rates and mortality after 3 months,6 months,12 months were recorded.Treatment effects of two groups were compared with continuously correction chi-square test,bleeding rates were compared with Fisher test,survival rates were analyzed with Kaplan-Meier survival curve and compared with Log-rank test.ResultsOverall the 40 experiences performed successfully without serious operation related complications.After 3 months later,the complete response,partial response,stable of disease and progressive disease are 0%?0/20??40%?8/20??30%?6/20?and 30%?6/20?in treatment group,0%?0/20?,5%?1/20?,30%?6/20?,65%?13/20?in control group,the overall effectiveness rates were 40%?8/20?and 5%?1/20?respectively,the difference of the overall effectiveness rates was statistically significant??2=5.161,P=0.023?.The bleeding rates at 3,6 and 12 months were 10%?2/20?,10%?2/20?,15%?3/20?in treatment group,for control group were 10%?2/20?,30%?6/20?,50%?10/20?correspondingly,there were no statistical different between the 3 months and 6 months bleeding rates?P=1,P=0.235?,for 12 months bleeding rates the difference were statistically significant?P=0.041?;After 12 months,the survival rates were 70%?14/20?in treatment group and 40%?8/20?in control group,the difference was statistically significant.ConclusionCT guided implantation of ¹²⁵iodine seeds can effectively treat portal vein tumor thrombus accompanying hepatocellular carcinoma with minimal damage and significantly reduced variceal bleeding rates.