Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 2, Number 3, June 2009, pages 141-147

¹²⁵I Radioactive Seeds Implantation Therapy for Hepatocellular Carcinoma

**Table 1.** Patient characteristics (n = 48)
Characteristic	Number of patients(%)
Age (mean)	32-86 years (59)
Gender
Male (%)	38(79.2%)
Female (%)	10(20.8%)
KPS
100	10(20.8%)
80	10(20.8%)
60	17(35.4%)
Viral antigen
HBV	38(79.2%)
HCV	10(20.8%)
AFP (ng/ml)
> 400	22(45.8%)
≤ 400	26(54.2%)
Tumor Size
< 5 cm	17(35.4%)
5-10 cm	23(47.9%)
> 10 cm	8(16.7%)
Tumor type
Single	14(29.2%)
Massive	34(70.8%)
Liver Child-Pugh
A	34(70.8%)
B	14(29.2%)
Okuda stage
I	22(45.8%)
II	24(50%)
III	2(4.2%)
AJCC stage
II	10(20.8%)
IIIa	20(41.7%)
IIIb	18(37.5%)
Prior TACE (%)
2	5(10.4%)
2+	43(89.6%)
TACE median sessions	4(95%CI,4-5)

Table 1. Patient characteristics (n = 48)

Characteristic

Number of patients(%)

Age (mean)

32-86 years (59)

Gender

Male (%)

38(79.2%)

Female (%)

10(20.8%)

KPS

100

10(20.8%)

17(35.4%)

Viral antigen

HBV

38(79.2%)

HCV

10(20.8%)

AFP (ng/ml)

> 400

22(45.8%)

≤ 400

26(54.2%)

Tumor Size

< 5 cm

17(35.4%)

5-10 cm

23(47.9%)

> 10 cm

8(16.7%)

Tumor type

Single

14(29.2%)

Massive

34(70.8%)

Liver Child-Pugh

34(70.8%)

14(29.2%)

Okuda stage

22(45.8%)

24(50%)

III

2(4.2%)

AJCC stage

10(20.8%)

IIIa

20(41.7%)

IIIb

18(37.5%)

Prior TACE (%)

5(10.4%)

43(89.6%)

TACE median sessions

4(95%CI,4-5)

**Table 2.** characteristics of ¹²⁵I brachytherapy
Characteristic	Number of patients (%)
mCi: millicuries; MPD: matched peripheral dose; Gy: gray.
Activity per seed
0.4 mCi	10 (20.8%)
0.7 mCi	23 (47.9%)
1.0 mCi	15 (31.3%)
Number of seeds
30-40	8 (16.7%)
41-60	21 (43.8%)
≥61	18 (37.5%)
Total activity
10-20 mCi	10 (20.8%)
21-30 mCi	30 (62.5%)
31-50 mCi	8 (16.7%)
MPD
60-80 Gy	12 (25%)
90-120 Gy	29 (60.4%)
130-160 Gy	7 (14.6%)
Number of implant sites
1	40(83.3%)
2	5(10.4%)
3	3(6.25%)

Table 2. characteristics of ¹²⁵I brachytherapy

Characteristic

Number of patients (%)

mCi: millicuries; MPD: matched peripheral dose; Gy: gray.

Activity per seed

0.4 mCi

10 (20.8%)

0.7 mCi

23 (47.9%)

1.0 mCi

15 (31.3%)

Number of seeds

30-40

8 (16.7%)

41-60

21 (43.8%)

≥61

18 (37.5%)

Total activity

10-20 mCi

10 (20.8%)

21-30 mCi

30 (62.5%)

31-50 mCi

8 (16.7%)

MPD

60-80 Gy

12 (25%)

90-120 Gy

29 (60.4%)

130-160 Gy

7 (14.6%)

Number of implant sites

40(83.3%)

5(10.4%)

3(6.25%)

**Table 3.** Response of unresectable hepatic tumor to ¹²⁵I brachytherapy
Response	Number of patients(%)
CR: complete response; PR: partial response; SD: stable disease; PD: progressive disease
CR	8 (16.7%)
PR	26 (54.2%)
SD	10 (20.8%)
PD	4 (8.3%)

Table 3. Response of unresectable hepatic tumor to ¹²⁵I brachytherapy

Response

Number of patients(%)

CR: complete response; PR: partial response; SD: stable disease; PD: progressive disease

8 (16.7%)

26 (54.2%)

10 (20.8%)

4 (8.3%)

**Table 4.** Acute toxicity of ¹²⁵I brachytherapy (n = 48)
	Toxicity grade
Transaminase	2	3	-	-
Bilirubin	1	2	-	-
Albumin	2	3	-	-
Alkaline phosphatase	2	2	-	-
Leucopenia	3	3	-	-
Anemia	5	2	-	-
Thrombocytopenia	1	3	-	-

Table 4. Acute toxicity of ¹²⁵I brachytherapy (n = 48)

Toxicity grade

Transaminase

Bilirubin

Albumin

Alkaline phosphatase

Leucopenia

Anemia

Thrombocytopenia

**Table 5.** Actuarial overall survival (n = 48)
Category	Number of Patients (%)
Number remaining alive	9 (18.8%)
Death of intrahepatic disease	16 (33.3%)
Death of extrahepatic disease	7 (14.6%)
Death of complications of further Treatment	10 (20.8%)
Death of unrelated cause	6 (12.5%)
Actuarial survival
1 year	75%
2 year	45.8%
3 year	27.1%
Median survival time	15.5 months (95%CI,12.7-27)

Table 5. Actuarial overall survival (n = 48)

Patient group	Survival rate(%)			Mean survival (months)	P
	1-Y	2-Y	3-Y
All patients	75%	45.8%	27.1%	24.2 (95% CI, 19.2-29.2)	-
Age(years)
<50	80%	60%	40%	28.9 (95% CI, 14.7-43.1)	0.4683
≥50	73.7%	42.1%	23.7%	22.9 (95% CI, 17.5-28.4)
Gender
Male	76.3%	44.7%	26.3%	22.9 (95% CI, 17.7-28.1)	0.5499
Female	70%	50%	30%	29.1 (95% CI, 13.1-45.1)
KPS					0.3461
100	80%	60%	40%	28.9 (95% CI, 14.7-43.1)	-
80	81%	57.1%	28.6%	26.5 (95% CI, 18.4-34.6)	-
60	64.7%	23.5%	17.6%	18.5 (95% CI, 11.2-25.8)	-
Tumor type
Single	92.9%	71.4%	64.3%	41.2 (95% CI, 29.8-52.6)	0.0001
Massive	67.6%	32.4%	11.8%	17.1 (95% CI, 13.7-20.6)
Tumor Size					0.0000
<5 cm	94.1%	70.6%	52.9%	35.5 (95% CI, 25.6-45.5)
5-10 cm	82.6%	43.5%	17.4%	21.1 (95% CI, 15.6-26.7)
>10 cm	12.5%	0%	0%	8.75 (95% CI, 6.9-10.6)
Okuda stage
I	95.4%	72.7%	45.5%	33 (95% CI, 25.3-40.7)	0.0011
II+III	57.7%	23.1%	11.5%	16.7 (95% CI, 11.3-22.1)
AJCC stage
II	90%	80%	70%	41.7 (95% CI, 28-55.4)	0.0011
IIIa+IIIb	71.1%	36.8%	15.8%	19.6 (95% CI, 15.1-24)
Liver Child–Pugh
A	85.3%	61.8%	35.3%	9.5 (95% CI, 23.4-35.5)	0.0000
B	35.7%	7.1%	7.1%	11.3 (95% CI, 6.6-16)
AFP(ng/ml)
> 400	59.1%	22.7%	9.1%	16.6 (95% CI, 11.1-22.1)	0.0013
≤ 400	88.5%	65.4%	42.3%	30.6 (95% CI, 23.2-38)
MPD					0.0223
60-80 Gy	66.7%	16.7%	8.3%	15.1 (95% CI, 9.2-21)
90-120 Gy	86.2%	58.6%	34.5%	29.1(95% CI, 22.3-36)
130-160 Gy	42.9%	28.6%	28.6%	20.6 (95% CI, 2-39.1)