Abstract: Objective:To study and observe the efficacy and safety of sequential transcatheter arterial chemoembolization (TACE) with ¹²⁵I seed bar combined with portal vein stent implantation under the guidance of double guidance technology in the treatment of primary hepatocellular carcinoma (HCC) complicated with portal vein tumor thrombus (PVTT).
Method:The clinical data of 140 HCC patients with PVTT treated in Hunan Provincial People's Hospital from July 2016 to July 2018 were retrospectively analyzed. According to the treatment methods, they were divided into 60 cases in the combined group (¹²⁵I particle strip combined with portal vein stent implantation sequential TACE treatment under the guidance of double guidance technology) and 80 cases in the simple group (TACE treatment alone). The short-term efficacy and survival of the two groups, the changes of tumor thrombus size before and after treatment were observed and compared changes of liver function and laboratory indexes.
Result:①Thirty days after operation, the remission rate of the combined group was 80.0%, and the total effective rate was 96.7%. The remission rate of the simple group was 58.8%, and the total effective rate was 85.0%. The remission rate and total effective rate of the combined group were significantly higher than those of the simple group (P<0.05). ②The area of tumor thrombus after operation was significantly smaller than that before operation in both groups (P<0.05); The area of postoperative tumor thrombus in the combined group was significantly smaller than that in the simple group (P<0.05). ③ The levels of glutamic-pyruvic transaminase (GPT), glutamic-oxaloacetic transaminase (GOT), total bilirubin (TBIL) in the two groups were significantly higher 7 days after operation than those before operation, and were significantly lower than those 30 days after operation. The analysis of variance within the two groups was statistically significant (P<0.05). The levels of GPT, GOT and TBIL in the combined group were significantly higher than those in the simple group 7 days after operation, and the levels of GPT, GOT and TBIL in the combined group 30 days after operation were significantly lower than those in the simple group, with statistical significance (P<0.05). ④The 3-year overall survival rate was 51.7% in the combined group and 23.8% in the simple group. The survival outcome of the combined group was significantly better than that of the simple group (P<0.05).
Conclusion:The short-term effect of sequential TACE guided by double guidance technology with ¹²⁵I particle strip combined with portal vein stent implantation in the treatment of HCC complicated with PVTT is better than that of TACE alone, which significantly increases the survival rate within 3 years, but the liver function injury caused by TACE should be prevented and treated in the process of treatment.

Key words: Double guidance technology, ¹²⁵I seed strip, Portal vein stent, Transcatheter arterial chemoembolization, Primary liver cancer, Hepatocellular carcinoma, Portal vein tumor thrombus