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Purpose <p>This study assessed the effectiveness and prognostic factors of CT-guided ¹²⁵I seed implantation for primary hepatocellular carcinoma (HCC).</p> Methods <p>A retrospective analysis of 71 patients (57 males, 14 females, median age 64) treated at three Chinese hospitals from 2018 to 2024 was conducted. The main outcomes were local progression-free survival (LPFS) and overall survival (OS). Treatment involved a 16-slice Spiral CT and Radioactive Particle Treatment Planning System (TPS), with seeds of 18.5–29.6 MBq implanted via freehand puncture. Efficacy was evaluated using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) at three months, with follow-ups every three months for three years, then biannually until December 2024. Data analysis utilized SPSS 22.0, Kaplan-Meier, and Cox models.</p> Results <p>With a median follow-up of 37 months, the complete response (CR) rate was 57.7%, partial response (PR) 31.0%, stable disease (SD) 5.6%, and progressive disease (PD) 5.6%. Local control was 94.3%. LPFS rates at 1, 3, and 5 years were 74.6%, 29.5%, and 1.4% (median LPFS 22 months), while overall survival (OS) rates were 88.7%, 47.8%, and 12.6% (median OS 35 months). CR was a key protective factor for LPFS and OS. Significant factors included the Barcelona Clinic Liver Cancer (BCLC) stage C, intrahepatic progression, and extrahepatic metastasis. Postoperative complications occurred in 35.2% of patients, with no severe cases.</p> Conclusion <p>CT-guided ¹²⁵I seed implantation is effective and safe for primary HCC, with CR being crucial for survival. Large-scale studies are needed to confirm these results.</p>

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Investigation into the efficiency and prognostic elements of CT-guided ¹²⁵I particle implantation for liver cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月11日

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  • Yuxiao Xia,
  • Quanyu Zhou,
  • Xue Jiang,
  • Wenling Tu,
  • Qian Liu,
  • Liangshan Li,
  • Yuhong Shi

摘要

Purpose

This study assessed the effectiveness and prognostic factors of CT-guided ¹²⁵I seed implantation for primary hepatocellular carcinoma (HCC).

Methods

A retrospective analysis of 71 patients (57 males, 14 females, median age 64) treated at three Chinese hospitals from 2018 to 2024 was conducted. The main outcomes were local progression-free survival (LPFS) and overall survival (OS). Treatment involved a 16-slice Spiral CT and Radioactive Particle Treatment Planning System (TPS), with seeds of 18.5–29.6 MBq implanted via freehand puncture. Efficacy was evaluated using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) at three months, with follow-ups every three months for three years, then biannually until December 2024. Data analysis utilized SPSS 22.0, Kaplan-Meier, and Cox models.

Results

With a median follow-up of 37 months, the complete response (CR) rate was 57.7%, partial response (PR) 31.0%, stable disease (SD) 5.6%, and progressive disease (PD) 5.6%. Local control was 94.3%. LPFS rates at 1, 3, and 5 years were 74.6%, 29.5%, and 1.4% (median LPFS 22 months), while overall survival (OS) rates were 88.7%, 47.8%, and 12.6% (median OS 35 months). CR was a key protective factor for LPFS and OS. Significant factors included the Barcelona Clinic Liver Cancer (BCLC) stage C, intrahepatic progression, and extrahepatic metastasis. Postoperative complications occurred in 35.2% of patients, with no severe cases.

Conclusion

CT-guided ¹²⁵I seed implantation is effective and safe for primary HCC, with CR being crucial for survival. Large-scale studies are needed to confirm these results.