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Adjuvant iodine-125 brachytherapy for hepatocellular carcinoma after complete hepatectomy: a randomized controlled trial.

Chen K, Xia Y, Wang H, Xiao F, Xiang G, Shen F - PLoS ONE (2013)

Bottom Line: The 1-, 3- and 5-year recurrence-free rates of the (125)I group were 94.12%, 76.42%, and 73.65% vs. 88.24%, 50.00%, and 29.41% compared with the control group, respectively.The 1-, 3- and 5-year OS rates of the (125)I group were 94.12%, 73.53%, and 55.88% vs. 88.24%, 52.94%, and 29.41% compared with the control group, respectively.Most frequent adverse events in the (125)I group included nausea, vomiting, arrhythmia, decreased white blood cell and/or platelet counts, and were generally mild and manageable.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, the Second Provincial People's Hospital of Guangdong Province, Guangzhou, P. R. China.

ABSTRACT

Background: Tumor recurrence is a major problem after curative resection of hepatocellular carcinoma (HCC). The current study evaluated the effects of adjuvant iodine-125 ((125)I) brachytherapy on postoperative recurrence of HCC.

Methodology/principal findings: From July 2000 to June 2004, 68 HCC patients undergoing curative hepatectomy were randomly assigned into a (125)I adjuvant brachytherapy group (n = 34) and a group of best care (n = 34). Patients in the (125)I adjuvant brachytherapy group received (125)I seed implantation on the raw surface of resection. Patients in the best care control group received identical treatments except for the (125)I seed implantation. Time to recurrence (TTR) and 1-, 3- and 5-year overall survival (OS) were compared between the two groups. The follow-up ended in January 2010, and lasted for 7.7-106.4 months with a median of 47.6 months. TTR was significantly longer in the (125)I group (mean of 60.0 months vs. 36.7 months in the control). The 1-, 3- and 5-year recurrence-free rates of the (125)I group were 94.12%, 76.42%, and 73.65% vs. 88.24%, 50.00%, and 29.41% compared with the control group, respectively. The 1-, 3- and 5-year OS rates of the (125)I group were 94.12%, 73.53%, and 55.88% vs. 88.24%, 52.94%, and 29.41% compared with the control group, respectively. The (125)I brachytherapy decreased the risk of recurrence (HR = 0.310) and the risk of death (HR = 0.364). Most frequent adverse events in the (125)I group included nausea, vomiting, arrhythmia, decreased white blood cell and/or platelet counts, and were generally mild and manageable.

Conclusions/significance: Adjuvant (125)I brachytherapy significantly prolonged TTR and increased the OS rate after curative resection of HCC.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12610000081011.

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Related in: MedlinePlus

Time to recurrence curves.Time to recurrence in patients in the adjuvant 125I brachytherapy vs. in the control group, log-rank, X2 = 7.04, p = 0.008.
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pone-0057397-g002: Time to recurrence curves.Time to recurrence in patients in the adjuvant 125I brachytherapy vs. in the control group, log-rank, X2 = 7.04, p = 0.008.

Mentions: At recurrence, the tumor was within the liver, with no extrahepatic recurrence in all cases. TTR in the adjuvant 125I brachytherapy group had a mean of 60.0 months (vs. 36.7 months in the control group). The rate of postoperative recurrence was 35.29% (12/34 patients) in the adjuvant 125I brachytherapy group as opposed to 70.59% (24/34 patients) in the control group (Figure 2). The 1-, 3- and 5-year recurrence-free rates of the 125I group were 94.12%, 76.42% and 73.65% vs. 88.24%, 50.00% and 29.41% of that in the control group (log-rank test, p = 0.008), respectively. There were two recurrence-free deaths in the adjuvant 125I brachytherapy group, which were also included and censored on the date of death in the Kaplan-Meier plot for the recurrence-free rate. The comparison of recurrence-free rate between the adjuvant 125I brachytherapy group and control group is presented in Figure 2.


Adjuvant iodine-125 brachytherapy for hepatocellular carcinoma after complete hepatectomy: a randomized controlled trial.

Chen K, Xia Y, Wang H, Xiao F, Xiang G, Shen F - PLoS ONE (2013)

Time to recurrence curves.Time to recurrence in patients in the adjuvant 125I brachytherapy vs. in the control group, log-rank, X2 = 7.04, p = 0.008.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585398&req=5

pone-0057397-g002: Time to recurrence curves.Time to recurrence in patients in the adjuvant 125I brachytherapy vs. in the control group, log-rank, X2 = 7.04, p = 0.008.
Mentions: At recurrence, the tumor was within the liver, with no extrahepatic recurrence in all cases. TTR in the adjuvant 125I brachytherapy group had a mean of 60.0 months (vs. 36.7 months in the control group). The rate of postoperative recurrence was 35.29% (12/34 patients) in the adjuvant 125I brachytherapy group as opposed to 70.59% (24/34 patients) in the control group (Figure 2). The 1-, 3- and 5-year recurrence-free rates of the 125I group were 94.12%, 76.42% and 73.65% vs. 88.24%, 50.00% and 29.41% of that in the control group (log-rank test, p = 0.008), respectively. There were two recurrence-free deaths in the adjuvant 125I brachytherapy group, which were also included and censored on the date of death in the Kaplan-Meier plot for the recurrence-free rate. The comparison of recurrence-free rate between the adjuvant 125I brachytherapy group and control group is presented in Figure 2.

Bottom Line: The 1-, 3- and 5-year recurrence-free rates of the (125)I group were 94.12%, 76.42%, and 73.65% vs. 88.24%, 50.00%, and 29.41% compared with the control group, respectively.The 1-, 3- and 5-year OS rates of the (125)I group were 94.12%, 73.53%, and 55.88% vs. 88.24%, 52.94%, and 29.41% compared with the control group, respectively.Most frequent adverse events in the (125)I group included nausea, vomiting, arrhythmia, decreased white blood cell and/or platelet counts, and were generally mild and manageable.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, the Second Provincial People's Hospital of Guangdong Province, Guangzhou, P. R. China.

ABSTRACT

Background: Tumor recurrence is a major problem after curative resection of hepatocellular carcinoma (HCC). The current study evaluated the effects of adjuvant iodine-125 ((125)I) brachytherapy on postoperative recurrence of HCC.

Methodology/principal findings: From July 2000 to June 2004, 68 HCC patients undergoing curative hepatectomy were randomly assigned into a (125)I adjuvant brachytherapy group (n = 34) and a group of best care (n = 34). Patients in the (125)I adjuvant brachytherapy group received (125)I seed implantation on the raw surface of resection. Patients in the best care control group received identical treatments except for the (125)I seed implantation. Time to recurrence (TTR) and 1-, 3- and 5-year overall survival (OS) were compared between the two groups. The follow-up ended in January 2010, and lasted for 7.7-106.4 months with a median of 47.6 months. TTR was significantly longer in the (125)I group (mean of 60.0 months vs. 36.7 months in the control). The 1-, 3- and 5-year recurrence-free rates of the (125)I group were 94.12%, 76.42%, and 73.65% vs. 88.24%, 50.00%, and 29.41% compared with the control group, respectively. The 1-, 3- and 5-year OS rates of the (125)I group were 94.12%, 73.53%, and 55.88% vs. 88.24%, 52.94%, and 29.41% compared with the control group, respectively. The (125)I brachytherapy decreased the risk of recurrence (HR = 0.310) and the risk of death (HR = 0.364). Most frequent adverse events in the (125)I group included nausea, vomiting, arrhythmia, decreased white blood cell and/or platelet counts, and were generally mild and manageable.

Conclusions/significance: Adjuvant (125)I brachytherapy significantly prolonged TTR and increased the OS rate after curative resection of HCC.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12610000081011.

Show MeSH
Related in: MedlinePlus