I125 irradiation stent for treatment of hepatocellular carcinoma with portal vein thrombosis: A meta-analysis.
Cancer Radiother
; 25(4): 340-349, 2021 Jun.
Article
em En
| MEDLINE
| ID: mdl-33455874
ABSTRACT
PURPOSE:
A meta-analysis aimed to systematically evaluate the safety and efficiency of I125 irradiation stent placement for patients with hepatocellular carcinoma (HCC) combined with portal vein tumor thrombosis (PVTT). MATERIALS ANDMETHODS:
The Cochrane library, PubMed/Medline, EMBASE, CNKI, Wanfang Data and CQVIP were systematically screened out from the earliest to December 2019. The qualities of all included studies were assessed. The primary endpoints were the 6-month, 12-month stent cumulative patency rate and 6-month, 12-month, 24-month overall survival rate while the secondary endpoints were the objective response rate of PVTT, main portal venous pressure changes and treatment-related adverse events. Our meta-analysis was conducted using Stata 12.0 software.RESULTS:
Totally seven studies with 1018 patients were included in the final analysis, in which 602 patients received TACE and I125 irradiation stent placement, and 416 patients in control group underwent TACE and stent placement without endovascular brachytherapy (EVBT). Meta-analysis showed that the I125 irradiation stent improved the cumulative stent patency rates in 6months [OR=1.65, 95% CI (1.32-2.05), P<0.001] and 12months [OR=2.55, 95% CI (1.90-3.42), P<0.001] and the survival rates in 6months [OR=1.77, 95% CI (1.41-2.22), P<0.001], 12months [OR=3.14, 95% CI (2.24-4.40), P<0.001] and 24months [OR=7.39, 95% CI (3.55-15.41), P<0.001]. However, there was no difference in the objective response rate of PVTT [OR=1.13, 95% CI (0.87-1.48), P=0.365], main portal venous pressure and the occurrence adverse event [OR=0.88, CI=0.72-1.08, P=0.212] between two groups.CONCLUSION:
I125 irradiation stent seems to be more effective in treating hepatocellular carcinoma with portal vein tumor thrombosis. The usage of portal vein stent combined endovascular brachytherapy has the potential to act as an alternative therapy for HCC with PVTT. On account of the limitation of studies included, more studies with high-level evidence, such as RCTs, are requisite to support the above promising results.Palavras-chave
Carcinome hépatocellulaire; Chimioembolisation transartérielle; Curiethérapie endovasculaire; Endovascular brathytherapy; Hepatocellular carcinoma; I(125) irradiation stent; Meta-analysis; Méta-analyse; Portal vein tumor thrombus; Stent d'iode125; Thrombose tumorale de la veine porte; Transarterial chemoembolization
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Veia Porta
/
Braquiterapia
/
Stents
/
Carcinoma Hepatocelular
/
Trombose Venosa
/
Radioisótopos do Iodo
/
Neoplasias Hepáticas
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Cancer Radiother
Assunto da revista:
NEOPLASIAS
/
RADIOTERAPIA
Ano de publicação:
2021
Tipo de documento:
Article