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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

Overall survival curves.OS in patients in the adjuvant 125I brachytherapy vs. in the control group, log-rank, X2 = 4.97, p = 0.026.
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pone-0057397-g003: Overall survival curves.OS in patients in the adjuvant 125I brachytherapy vs. in the control group, log-rank, X2 = 4.97, p = 0.026.

Mentions: Fifteen and 24 patients (44.11% and 70.59%) died in the adjuvant 125I brachytherapy and the control groups, respectively. Major causes of death included hepatic and renal failure as well as cachexia resulting from tumor recurrence, with the exception of cerebrovascular accidents and coronary heart disease in two cases in the adjuvant 125I brachytherapy group. The mean OS was 63.6 months and 38.9 months in the adjuvant 125I brachytherapy group and the control group, respectively. The 1-, 3- and 5-year OS rates of the adjuvant 125I brachytherapy group and control group were 94.12%, 73.53% and 55.88% vs. 88.24%, 52.94% and 29.41% (Kaplan-Meier, log-rank test, p = 0.026, Figure 3), respectively. The OS rate of the adjuvant 125I brachytherapy group was significantly higher than that of the control group.


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)

Overall survival curves.OS in patients in the adjuvant 125I brachytherapy vs. in the control group, log-rank, X2 = 4.97, p = 0.026.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0057397-g003: Overall survival curves.OS in patients in the adjuvant 125I brachytherapy vs. in the control group, log-rank, X2 = 4.97, p = 0.026.
Mentions: Fifteen and 24 patients (44.11% and 70.59%) died in the adjuvant 125I brachytherapy and the control groups, respectively. Major causes of death included hepatic and renal failure as well as cachexia resulting from tumor recurrence, with the exception of cerebrovascular accidents and coronary heart disease in two cases in the adjuvant 125I brachytherapy group. The mean OS was 63.6 months and 38.9 months in the adjuvant 125I brachytherapy group and the control group, respectively. The 1-, 3- and 5-year OS rates of the adjuvant 125I brachytherapy group and control group were 94.12%, 73.53% and 55.88% vs. 88.24%, 52.94% and 29.41% (Kaplan-Meier, log-rank test, p = 0.026, Figure 3), respectively. The OS rate of the adjuvant 125I brachytherapy group was significantly higher than that of the control group.

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