The Clinical Research Of Primary Liver Cancer Patients Treated With (125)~I Radioactive Seed Implantation

Primary liver cancer ofen has no clinical symptoms, once found , it's ofen came to an advanced stage and lost the opportunities of hepatectomy. Transcatheter arterial chemoembolization (TACE) has been widely used in primary and metastatic liver cancer, but when the tumor is larger, has more blood support and collateral circulation, the clinical effect of TACE is not so satisfactory. While the ablation is only suitabel for liver cancer less than 5 centimeters. The liver is an radiosensitivity organ, radioactive ¹²⁵I seeds can releaseγ-ray which can effectively cover the tumor regin and sub-region, theγ-ray can continuing kill the tumor. This operation has the advantages of safety, easy oprated, and the patients can easily acceptted, so it has been widely used in clinical. This article is to oboserve the postoperative complications and survival of the 30 primary liver cancer patients who had accepted the therapy of radioactive ¹²⁵I seed implantation, and demonstrate the advantages of radioactive ¹²⁵I seeds implantation.Objective: to reserch the meanings of ¹²⁵I seed implantation in the therapy of primary liver cancer.Methods: 30 cases of primary liver cancer patients using ¹²⁵I radioactive seed implantation therapy in China-Japan unin Hospital of Jilin University from May 2005 to Feb 2010, 22cases of male, 8 cases of female, age from 38 to 77 years old, the average is 57.4 years. 3 cases of primary cancer that located in the left lobe , 19 cases in the right lobe, 7 cases in the left and right lobe, and 1 case in the caudate lobe. Of those 9 cases have portal vein thrombosis, of which 1 case with superior mesenteric vein thrombosis. The liver function is according to the modified Child-pugh classification, 20 cases are A level and 10 cases are B level. In accordance with the Professional Committee of Chinese Anti-Cancer Association of liver cancer Primary liver cancer in 2001 revised staging criteria, there are 2 cases of stage Ia, 5 cases of stage Ib, 7 cases of stage IIa, 6 cases of stage IIb, and 10 cases of stage IIIa. Of those 23 cases are advanced liver cancer, according for 76.7%. 30 patients all accepted the percutaneous ultrasound / CT guided radioactive ¹²⁵I seed implantation. To obeserve and analys the postoperation implications, and compare the survival with the published data which associated with the interventional theraphy, so as to sure the advanteges of ¹²⁵I seed implatation .Results: 30 cases were followed up for more than one year, so far 17 patients died, 13 survived, the 1-year and 3-year survival rates were 73.3% and 16.7%, higher than those of treated with TACE, whoes 1-year and 3-year survival rates were 62.2%,12.9%. The midian survival was 17.2 months, higher than 16.2 months of TACE. We analys the midian survival of radioactive seed implantation and TACE with a single sample t test, P = 0.222> 0.05, the difference was not statistically significant. 9 patients with portal vein tumor thrombus, the 1-year, 3-year survival rates were 44.4%, 11.1%, higher than the 1, 3-year survival rate after TAE, whose datas were 37.2% and 6.2%; the median survival was 6.0 months, lower than the 10 months of TAE. The 9 cases of HCC with portal vein tumor thrombus underwent radioactive seed ¹²⁵I implantation in treatment, the survival compared with median survival TAE 10 months with single sample t test, P = 0.881> 0.05, the difference has no statistically significance. Among 30 patients after ¹²⁵I radioactive seed implantation treatment, 24 patients with no postopratation symptoms, according for 80%, the most common complication was upper abdominal pain and discomfort, the rate was 13.3%; The most common complication of TACE is embolization comprehensive symptom, the rate was 40-90%, followed by ascites, the rate was 4-20%,radioactive ¹²⁵I.seed implantation has a lower rate of postopratation symptoms.Conclusion: 1. ¹²⁵I radioactive particles can extend the survival time of primary liver cancer . 2. This method is safe and effective, easy to operate, less side effects and less post-operative complications, is an effective treatment of liver cancer.