Zhang Y, Wu YF, Yue ZD, Zhao HW, Wang L, Fan ZH, He FL, Wang T, Liu FQ. Iodine-125 implantation with transjugular intrahepatic portosystemic shunt for main portal vein tumor thrombus. World J Gastrointest Oncol 2019; 11(4): 310-321 [PMID: 31040896 DOI: 10.4251/wjgo.v11.i4.310]
Corresponding Author of This Article
Fu-Quan Liu, BCPS, MD, Professor, Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing 100010, China. lfuquan@aliyun.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Cohort Study
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Zhang Y, Wu YF, Yue ZD, Zhao HW, Wang L, Fan ZH, He FL, Wang T, Liu FQ. Iodine-125 implantation with transjugular intrahepatic portosystemic shunt for main portal vein tumor thrombus. World J Gastrointest Oncol 2019; 11(4): 310-321 [PMID: 31040896 DOI: 10.4251/wjgo.v11.i4.310]
World J Gastrointest Oncol. Apr 15, 2019; 11(4): 310-321 Published online Apr 15, 2019. doi: 10.4251/wjgo.v11.i4.310
Iodine-125 implantation with transjugular intrahepatic portosystemic shunt for main portal vein tumor thrombus
Yue Zhang, Yi-Fan Wu, Zhen-Dong Yue, Hong-Wei Zhao, Lei Wang, Zhen-Hua Fan, Fu-Liang He, Tao Wang, Fu-Quan Liu
Yue Zhang, Fu-Quan Liu, Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
Yi-Fan Wu, Zhen-Dong Yue, Hong-Wei Zhao, Lei Wang, Zhen-Hua Fan, Fu-Liang He, Department of Interventional Therapy, Beijing Shijitan Hospital and Capital Medical University, Beijing 100038, China
Tao Wang, Department of Interventional Therapy, The affiliated Yantai Yuhuangding Hospital of Qingdao University, No.20 Yuhuangding East Road, Yantai 264000, Shandong Province, China
Author contributions: Liu FQ designed the research; Wu YF, Yue ZD, Zhao HW, Wang L, Fan ZH and He FL performed the research; Zhang Y analyzed the data and wrote the paper; Wu YF and Liu FQ critically revised the manuscript for important intellectual content.
Supported bythe Beijing Municipal Science and Technology Commission project, the Capital of the Public Health Cultivation - Transcatheter Implantation combined with TACE/TAE in the treatment of portal vein tumor thrombus in clinical research, No. Z171100000417031.
Institutional review board statement: All patients involved in this study gave their informed consent. Institutional review board approval of our hospital was obtained for this study.
Informed consent statement: Written informed consent was obtained from all subjects (patients) in this study.
Conflict-of-interest statement: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
STROBE statement: The STROBE Statement has been adopted.
Corresponding author: Fu-Quan Liu, BCPS, MD, Professor, Department of Interventional Therapy, Peking University Ninth School of Clinical Medicine, Beijing Shijitan Hospital and Capital Medical University, No. 10 Tie Yi Road, Yangfangdian, Haidian District, Beijing 100010, China. lfuquan@aliyun.com
Telephone: +86-13701179758
Received: January 13, 2019 Peer-review started: January 14, 2019 First decision: January 26, 2019 Revised: February 11, 2019 Accepted: March 12, 2019 Article in press: March 12, 2019 Published online: April 15, 2019 Processing time: 93 Days and 2.9 Hours
ARTICLE HIGHLIGHTS
Research background
The main portal vein tumor thrombus (MPVTT), which is the major complication of terminal hepatocellular carcinoma (HCC) and causes portal hypertension, seriously affects the prognosis of liver cancer. MPVTT causes portal hypertension, which leads to many complications, such as ascites and hemorrhage of the digestive tract.
Research motivation
For patients with MPVTT, the ideal treatment should improve survival rate, reduce portal vein pressure, and avoid ascites and gastrointestinal bleeding, and the main objectives are to eliminate TT and recanalization of the PV.
Research objectives
Transjugular intrahepatic portosystemic shunt (TIPS) has been widely performed for the treatment of portal hypertension because it is minimally invasive and is reported to be effective.
Research methods
Some studies have reported that treatment of HCC with 125I implantation can reduce the volume of PVTT, which can improve the survival rate of patients. Thus, data analysis was adopted to analyze patient outcome in two groups with different treatments (plus or non-plus 125I implantation). However, 125I implantation documented in the literature was in the form of particle strands, which cannot be adjusted in position and implanted in limited numbers.
Research results
125I combined with TIPS can fix the particles between the stent and the TT without the need for particle strands.
Research conclusions
This approach allows for easier adjustment of the position of 125I and the amount of 125I being implanted. It can significantly enhance the survival rate of patients. TIPS combined with 125I can also reduce stent restenosis rate and symptom recurrence rate, and it is safe and feasible. However, the radiation dose is not uniformly distributed and particle fixation needs to be strengthened.
Research perspectives
In the present study, we used 125I combined with TIPS for the treatment of MPVTT and fixed the 125I particles between the stent and TT, without the need for particle strands. This approach allows for easier adjustment of the position of 125I and the amount being implanted. The direction of future research should aim to find new methods that are minimally invasive and more effective.
