CLINICAL TRIAL article
Front. Med.
Sec. Nuclear Medicine
This article is part of the Research TopicCancer Immunity, Modern Radiotherapy and Immunotherapy: A Journey into Cancer Treatment InnovationView all 9 articles
The Efficacy and Safety of PD-1 Inhibitors Combined with 125I Seed Implantation in Treating Extrahepatic Metastasis of Hepatocellular Carcinoma
Provisionally accepted
- 1Jiangxi Cancer Hospital, Nanchang, China
- 2Nanchang University Jiangxi Medical College, Nanchang, China
- 3Nanchang University Second Affiliated Hospital, Nanchang, China
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Patients with advanced hepatocellular carcinoma (HCC) and extrahepatic metastases face a poor prognosis with limited treatment options. We conducted a retrospective study of 84 such patients treated between January 2018 and April 2025 with either PD-1 inhibitor immunotherapy alone or in combination with iodine-125 (¹²⁵I) seed brachytherapy. Propensity score matching (PSM) yielded 25 patient pairs for outcome comparison. The combination therapy achieved significantly better local tumor control than monotherapy. Progression-free survival was prolonged with the combined treatment (median PFS 22.06 vs 9 months, p = 0.03), although overall survival was not significantly different between the groups. Both treatments markedly reduced serum alpha-fetoprotein levels and alleviated cancer-elated pain, with significant pain score improvements from baseline in each group. No severe treatment-related complications or deaths occurred. Multivariate analysis indicated that adding ¹²⁵I seed implantation was an independent protective factor for disease progression control. In conclusion, combining PD-1 inhibitors with ¹²⁵I seed implantation is a safe and effective strategy to improve local tumor control and progression-free survival in metastatic HCC, although the benefit in overall survival is limited. Further studies are needed to optimize this combined therapy, assess systemic immune effects, and improve long-term outcomes.
Keywords: Hepatocellular Carcinoma, Extrahepatic metastasis, PD-1 inhibitors, Iodine-125 brachytherapy, abscopal effect, Immunotherapy
Received: 27 Aug 2025; Accepted: 28 Oct 2025.
Copyright: © 2025 Tang, Yu, Chen, Tan, Wei and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaoyong Wei, 41906001@qq.com
Zhijun Chen, zhijunchen361@163.com
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