The Early Evaluation of Ultrasound-Guided Iodine-125 Interstitial Implants for High-Risk Hepatocellular Carcinoma

INTRODUCTION: To evaluate the feasibility and safety of ultrasound-guided iodine-125 interstitial implants for high-risk hepatocellular carcinoma. METHODS: From October, 2016, to August, 2018, 49 patients suffering from a total of 66 hepatocellular carcinoma lesions were treated with ultrasound-guided iodine-125 interstitial implantation. Treatment planning system was applied to make preoperative plan. The response evaluation criteria in solid tumors were used to evaluate the curative effect. The evaluated outcomes included postoperative complications and complete disease control rate, 6-month disease-free survival, and 6-month overall survival. RESULTS: All 49 patients underwent iodine-125 seed implantation successfully. Patients were followed up for 5 to 27.5 months. No patients developed serious complications and only 2 (4.1%) patients had slight pain. The complete response was seen in 21 lesions (31.8%), partial response in 26 lesions (39.4%), stable disease in eight lesions (12.1%), and progressive disease in 11 lesions (16.7%). The overall disease control rate was reached to 83.3%. The 6-month disease-free survival rate was 46.4% with a median disease-free survival time of 5.0 months. The 6-month overall survival rate was 83.6% with a median overall survival time of 15.0 months. CONCLUSIONS: Iodine-125 interstitial implantation is a kind of safe and feasible treatment for high-risk hepatocellular carcinoma. (C) 2019 Published by Elsevier Inc. on behalf of American Brachytherapy Society.