Safety and efficacy of ¹²⁵I brachytherapy for bilateral lung recurrences from hepatocellular carcinoma after resection or ablation

Purpose: To evaluate the safety and efficacy of ¹²⁵I brachytherapy to treat bilateral lung recurrences from hepatocellular carcinoma (HCC) after resection or ablation.

Materials and methods: We retrospectively recruited 95 patients with bilateral lung recurrences from hepatocellular carcinoma (HCC) after resection or ablation who had received 3-6-month sorafenib with or without stereotactic body radiotherapy (SBRT), from October 2011 to January 2015; patients were then randomly divided into two groups, 44 patients received computed tomography (CT)-guided ¹²⁵I brachytherapy (group A), and 51 patients were treated with supportive and symptomatic treatments (group B).

Results: The median survival time was 19 months (range of 3-36 months). The local response rate (LRR) at 3, 6, 12, 18, 24, 30 and 36 months in group A was 81.8%, 65.9%, 59.1%, 45.0%, 38.6%, 22.7%, 11.4%, respectively, and 64.7%, 47.1%, 33.3%, 25.4%, 15.7%, 11.7%, 7.8%, respectively, in group B (P < 0.05). The mean progression-free survival time (PFST) and overall survival (OS) of group A were significantly longer than those of group B. Alpha fetoprotein (AFP) and tumor size were independent factors that affected the PFST and OS, normal AFP levels and less than 1-cm tumor diameter had better PFST and OS (P < 0.05). No massive bleeding or serious complications occurred.

Conclusion: CT-guided ¹²⁵I brachytherapy is safe and effective for the treatment of bilateral lung recurrences from HCC after resection or ablation.