CT-Guided 125I Brachytherapy in the Treatment of Hepatocellular Carcinoma Refractory to Conventional Transarterial Chemoembolization: A Pilot Study

Xinjian Xu,1,* Yiwen Ding,1,* Tianfan Pan,1 Feng Gao,1 Xiangzhong Huang,1 Qiulian Sun2 1Department of Interventional Radiology, Jiangyin People’s Hospital, Jiang Yin City, Jiangsu Province, 214400, People’s Republic of China; 2Department of Radiology, Zhejiangtaizhou Hospital, Taizhou City, Zhejiang Province, 317000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiangzhong Huang; Qiulian Sun Email hxzdoc@163.com; sql947435865@163.comPurpose: To investigate the efficacy and safety of CT-guided 125I brachytherapy in the treatment of hepatocellular carcinoma (HCC) refractory to conventional transarterial chemoembolization (TACE).Methods: Nineteen patients with TACE-refractory HCC treated with CT-guided 125I brachytherapy between June 2017 and June 2020 at Jiangyin People’s Hospital were enrolled in this study. In addition, we used the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria to evaluate the treatment response after 125I brachytherapy.Results: Twenty-one tumours were treated with CT-guided 125I brachytherapy in nineteen patients. Twelve tumours (57.1%) showed a complete response, and a partial response was observed in seven tumours (33.3%). The six-month objective response rate was 90.5% (19/21). The adverse effects of CT-guided 125I brachytherapy were tolerable.Conclusion: Our preliminary clinical experience demonstrated that CT-guided 125I brachytherapy was effective and well tolerated for the treatment of TACE-refractory HCC, suggesting that CT-guided 125I brachytherapy has the potential to become an effective alternative treatment for TACE-refractory HCC.Keywords: 125I brachytherapy, TACE, refractory, hepatocellular carcinoma