Purpose: To evaluate the safety and efficacy of I seed strand combined with percutaneous transhepatic biliary drainage (PTBD) and hepatic arterial infusion chemotherapy (HAIC) for unresectable Bismuth-Corlette III and IV stage hilar cholangiocarcinoma (HCCA).
Methods: From January 2018 to December 2021, a total of 128 Bismuth-Corlette III and IV stage HCCA patients with obstructive jaundice were included in this single-center retrospective study. Forty-eight patients underwent I seed strand combined with PTBD and HAIC (group A). The mean intended dose (r = 10 mm; z = 0; 240 days) in group A was 63.8 ± 0.6 Gy. Eighty cases underwent PTBD plus HAIC (group B). Median overall survival (OS) and median bile duct patency time (BDPT) were compared between the two groups.
Results: In the propensity-score matched (PSM) cohort, the median OS and median BDPT were significantly longer in group A than in group B (44 PSM pairs; OS, 13.6 ± 0.4 vs. 8.7 ± 1.4 months, p < 0.001; BDPT, 12.1 ± 0.5 vs. 6.4 ± 0.7 months, p < 0.001). Multivariate analysis revealed that the treatment regimen was an independent prognostic factor of OS. There were no serious complications related to I seed strand implantation.
Conclusions: I seed strand combined with PTBD and HAIC for unresectable Bismuth-Corlette III and IV stage HCCA is safe and effective.
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