Adjuvant Iodine-125 Brachytherapy for Hepatocellular Carcinoma after Complete Hepatectomy: A Randomized Controlled Trial

Chen, Kaiyun; Xia, Yong; Wang, Hanning; Xiao, Fanglian; Xiang, Guoan; Shen, Feng
February 2013
PLoS Clinical Trials;Feb2013, Vol. 8 Issue 2, p1
Academic Journal
Background: Tumor recurrence is a major problem after curative resection of hepatocellular carcinoma (HCC). The current study evaluated the effects of adjuvant iodine-125 (125I) 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 125I adjuvant brachytherapy group (n = 34) and a group of best care (n = 34). Patients in the 125I adjuvant brachytherapy group received 125I seed implantation on the raw surface of resection. Patients in the best care control group received identical treatments except for the 125I 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 125I group (mean of 60.0 months vs. 36.7 months in the control). 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% compared with the control group, respectively. The 1-, 3- and 5-year OS rates of the 125I group were 94.12%, 73.53%, and 55.88% vs. 88.24%, 52.94%, and 29.41% compared with the control group, respectively. The 125I brachytherapy decreased the risk of recurrence (HR = 0.310) and the risk of death (HR = 0.364). Most frequent adverse events in the 125I group included nausea, vomiting, arrhythmia, decreased white blood cell and/or platelet counts, and were generally mild and manageable. Conclusions/Significance: Adjuvant 125I brachytherapy significantly prolonged TTR and increased the OS rate after curative resection of HCC. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12610000081011.


Related Articles

  • Controversies and challenges in the management of well-differentiated thyroid cancer. Iyer, N.; Shaha, Ashok // Indian Journal of Surgery;Dec2009, Vol. 71 Issue 6, p299 

    The incidence of well-differentiated thyroid cancer has seen a worldwide increase in the last three decades, although whether this is due to a ‘true increase’ in incidence or simply increased detection of otherwise subclinical disease remains undetermined. Nonetheless, this rising...

  • The role of radioactive iodine-125 seed localization in breast-conserving therapy following neoadjuvant chemotherapy. Gobardhan, P. D.; de Wall, L. L.; van der Laan, L.; ten Tije, A. J.; van der Meer, D. C. H.; Tetteroo, E.; Poortmans, P. M. P.; Luiten, E. J. T. // Annals of Oncology;Mar2013, Vol. 24 Issue 3, p668 

    Background Neoadjuvant chemotherapy (NAC) is increasingly used in the framework of breast-conserving therapy (BCT). Localization of the initial tumor is essential to guide surgical resection after NAC. This study describes the results obtained with I-125 seed localization in BCT including NAC....

  • Recurrence of Hepatocellular Carcinoma in Noncirrhotic Liver After Hepatectomy. Chiche, Laurence; Menahem, B.; Bazille, C.; Bouvier, V.; Plard, L.; Saguet, V.; Alves, A.; Salame, E. // World Journal of Surgery;Oct2013, Vol. 37 Issue 10, p2410 

    Background: Hepatocellular carcinoma in noncirrhotic liver (HCCNC) is rare. This tumor has a particular epidemiology and presentation, and it requires specific treatment, compared with HCC in cirrhotic liver. The aims of this study were to determine the survival and recurrence rates, prognostic...

  • Postoperative Use of Radioiodine (131-I): Review of Recommendations and Guidelines. Prpić, Marin; Jukić, Tomislav; Murgić, Jure; Borić, Marta; Staničić, Josip; Kusić, Zvonko // Collegium Antropologicum;Jun2011, Vol. 35 Issue 2, p587 

    In the management of large number of patients with differentiated thyroid cancer, the radioactive iodine (131-I) administration plays an important role. The guidelines of numerous international and national medical societies regarding the issue of postoperative 131-I administration have been...

  • Adjuvant Radioactive Iodine Use Among Differentiated Thyroid Cancer Patients in the Military Health System. Gill, Abegail A.; Enewold, Lindsey; Zahm, Shelia H.; Shriver, Craig D.; Li Zheng; McGlynn, Katherine A.; Kangmin Zhu // Military Medicine;Sep2014, Vol. 179 Issue 9, p1043 

    Objective: Adjuvant radioactive iodine (RAI) for the treatment of differentiated thyroid cancer has been associated with better prognosis, but no consensus has been reached on the best practices for RAI. Limited data on RAI use and factors associated with the receipt of postoperative RAI in the...

  • A comparison of targetting of neuroblastoma with mIBG and anti L1-CAM antibody mAb chCE7: therapeutic efficacy in a neuroblastoma xenograft model and imaging of neuroblastoma patients. Hoefnagel, C.A.; Rutgers, M.; Buitenhuis, C.K.M.; Smets, L.A.; de Kraker, J.; Meli, M.; Carrel, F.; Amstutz, H.; Schubiger, P.A.; Novak-Hofer, I. // European Journal of Nuclear Medicine;2001, Vol. 28 Issue 3, p359 

    Abstract. Iodine-131 labelled anti L1-CAM antibody mAb chCE7 was compared with the effective neuroblastoma-seeking agent [sup 131]I-labelled metaiodobenzylguanidine (MIBG) with regard to (a) its therapeutic efficacy in treating nude mice with neuroblastoma xenografts and (b) its tumour...

  • I-131 treatment, smoking increased risk for thyroid-associated ophthalmopathy.  // Endocrine Today;Nov2009, Vol. 7 Issue 13, p30 

    This article discusses a study examined radioiodine treatment as a risk factor for the development of thyroid-associated ophthalmopathy in Graves' hyperthyroidism.

  • Iodine radioactive.  // Reactions Weekly;8/25/2012, Issue 1416, p25 

    The article describes the case of a 17-year-old boy who developed hyperparathyroidism after receiving radioactive iodine.

  • Discovery and Validation of Novel Expression Signature for Postcystectomy Recurrence in High-Risk Bladder Cancer. Mitra, Anirban P.; Lam, Lucia L.; Ghadessi, Mercedeh; Erho, Nicholas; Vergara, Ismael A.; Alshalalfa, Mohammed; Buerki, Christine; Haddad, Zaid; Sierocinski, Thomas; Triche, Timothy J.; Skinner, Eila C.; Davicioni, Elai; Daneshmand, Siamak; Black, Peter C. // JNCI: Journal of the National Cancer Institute;Nov2014, Vol. 106 Issue 11, p1 

    Background Nearly half of muscle-invasive bladder cancer patients succumb to their disease following cystectomy. Selecting candidates for adjuvant therapy is currently based on clinical parameters with limited predictive power. This study aimed to develop and validate genomic-based signatures...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics