Effect of transjugular intrahepatic portosystemic shunt combined with I particle implantation on portal vein tumor thrombus in hepatocellular carcinoma.

Objective: The efficacy of transjugular intrahepatic portosystemic shunt (TIPS) combined with I particle implantation in the treatment of portal vein tumor thrombus (PVTT) in hepatocellular carcinoma was discussed and analyzed in this study.

Methods: A total of 127 patients with primary hepatocellular carcinoma (PHC) complicated with PVTT admitted to our hospital from March 2017 to June 2018 were enrolled. The patients were classified into an observation group (n=69) and a control group (n=58) in the light of the different treatment methods. The control group patients were treated with TIPS alone, and the observation group patients received I particle implantation on the basis of TIPS in the control group. Subsequently, the clinical therapeutic efficacy, perioperative indicators, postoperative complications, quality of life and survival of patients before and after treatment were compared between the two groups.

Results: The remission rate in the observation group was remarkably higher than that of the control group (), and the difference in the overall response rate (ORR) of the two groups of patients was not statistically significant (). The AFP, PLT, WBC and the diameter of the main portal vein in the two groups dropped substantially compared to those before treatment (), and the AFP and the diameter of the main portal vein in the observation group were notably lower than those in the control group (). After treatment, the ALT, AST and TBiL of the two groups were remarkably higher than those before treatment (), and these indicators in the observation group were apparently higher than those in the control group (). There was no significant difference in the incidence of postoperative gastrointestinal bleeding, fever, granulocytopenia and abnormal hepatic dysfunction between the observation group and the control group (). The functional assessment of cancer therapy-hepatobiliary (FACT-Hep) scores of the two groups 6 months after operation was substantially lower than pre-op scores (), and the observation group had apparently lower postoperative scores than the control group (). The progression-free survival (PFS) and overall survival (OS) in the observation group were critically superior to those in the control group ().

Conclusion: TIPS combined with I particle implantation in the treatment of PHC patients with PVTT can help improve patients' clinical treatment efficacy after surgery while prolonging their postoperative survival. The treatment is safe and worthy of clinical promotion.