Endovascular placement of iodine-125 seed strand and stent combined with chemoembolization for treatment of hepatocellular carcinoma with tumor thrombus in main portal vein.

Purpose: To study the safety and feasibility of endovascular placement of an iodine-125 ((125)I) seed strand and stent combined with chemoembolization to treat hepatocellular carcinoma (HCC) with tumor thrombus in the main portal vein (MPV).

Materials And Methods: From February 2008 to October 2009, 32 patients with HCC complicated by tumor thrombus in MPV were enrolled into this study (28 men and 4 women, mean age 53.2 years ± 8.8). After (125)I seed strand and self-expandable stent had been placed in the obstructed MPV, chemoembolization was performed. All patients were followed up every 30 days. Patency of stent and response of HCC were evaluated by abdominal contrast-enhanced computed tomography (CT) scan.

Results: The technical success rate was 100% for placement of the (125)I seed strand and stent in the obstructed MPV. No serious procedure-related complications occurred. During a mean follow-up of 217.5 days ± 151.6, the objective response rate of HCC to chemoembolization was 37.5%. The 90-day, 180-day, and 360-day cumulative survival rates were 96.4%, 67.4%, and 39.3%, and the cumulative stent patency rates were 96.7%, 83.4%, and 83.4%.

Conclusions: Endovascular placement of (125)I seed strand and stent combined with chemoembolization was safe and feasible to treat HCC with tumor thrombus in the MPV.