Radioembolisation in patients with hepatocellular carcinoma that have previously received liver-directed therapies

on behalf of the European Network on Radioembolization with Yttrium-90 resin microspheres (ENRY)

Research output: Contribution to journalArticle

Abstract

Purpose: Radioembolisation is part of the multimodal treatment of hepatocellular carcinoma (HCC) at specialist liver centres. This study analysed the impact of prior treatment on tolerability and survival following radioembolisation. Methods: This was a retrospective analysis of 325 consecutive patients with a confirmed diagnosis of HCC, who received radioembolisation with yttrium-90 resin microspheres at eight European centres between September 2003 and December 2009. The decision to treat was based on the clinical judgement of multidisciplinary teams. Patients were followed from the date of radioembolisation to last contact or death and the nature and severity of all adverse events (AEs) recorded from medical records. Results: Most radioembolisation candidates were Child-Pugh class A (82.5%) with multinodular HCC (75.9%) invading both lobes (53.1%); 56.3% were advanced stage. Radioembolisation was used first-line in 57.5% of patients and second-line in 34.2%. Common prior procedures were transarterial (chemo)embolisation therapies (27.1%), surgical resection/transplantation (17.2%) and ablation (8.6%). There was no difference in AE incidence and severity between prior treatment subgroups. Median (95% confidence interval [CI]) survival following radioembolisation was similar between procedure-naive and prior treatment groups for Barcelona Clinic Liver Cancer (BCLC) stage A: 22.1 months (15.1–45.9) versus 30.9 months (19.6–46.8); p = 0.243); stage B: 18.4 months (11.2–19.4) versus 22.8 months (10.9–34.2); p = 0.815; and stage C: 8.8 months (7.1–10.8) versus 10.8 months (7.7–12.6); p = 0.976. Conclusions: Radioembolisation is a valuable treatment option for patients who relapse following surgical, ablative or vascular procedures and remain suitable candidates for this treatment.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
DOIs
Publication statusAccepted/In press - Mar 7 2018

Fingerprint

Hepatocellular Carcinoma
Liver
Therapeutics
Yttrium
Combined Modality Therapy
Survival
Liver Neoplasms
Microspheres
Medical Records
Blood Vessels
Transplantation
Confidence Intervals
Recurrence
Incidence

Keywords

  • Hepatocellular carcinoma
  • Radioembolisation
  • Selective internal radiation therapy
  • Yttrium-90 resin microspheres

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Radioembolisation in patients with hepatocellular carcinoma that have previously received liver-directed therapies. / on behalf of the European Network on Radioembolization with Yttrium-90 resin microspheres (ENRY).

In: European Journal of Nuclear Medicine and Molecular Imaging, 07.03.2018, p. 1-10.

Research output: Contribution to journalArticle

on behalf of the European Network on Radioembolization with Yttrium-90 resin microspheres (ENRY). / Radioembolisation in patients with hepatocellular carcinoma that have previously received liver-directed therapies. In: European Journal of Nuclear Medicine and Molecular Imaging. 2018 ; pp. 1-10.
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abstract = "Purpose: Radioembolisation is part of the multimodal treatment of hepatocellular carcinoma (HCC) at specialist liver centres. This study analysed the impact of prior treatment on tolerability and survival following radioembolisation. Methods: This was a retrospective analysis of 325 consecutive patients with a confirmed diagnosis of HCC, who received radioembolisation with yttrium-90 resin microspheres at eight European centres between September 2003 and December 2009. The decision to treat was based on the clinical judgement of multidisciplinary teams. Patients were followed from the date of radioembolisation to last contact or death and the nature and severity of all adverse events (AEs) recorded from medical records. Results: Most radioembolisation candidates were Child-Pugh class A (82.5{\%}) with multinodular HCC (75.9{\%}) invading both lobes (53.1{\%}); 56.3{\%} were advanced stage. Radioembolisation was used first-line in 57.5{\%} of patients and second-line in 34.2{\%}. Common prior procedures were transarterial (chemo)embolisation therapies (27.1{\%}), surgical resection/transplantation (17.2{\%}) and ablation (8.6{\%}). There was no difference in AE incidence and severity between prior treatment subgroups. Median (95{\%} confidence interval [CI]) survival following radioembolisation was similar between procedure-naive and prior treatment groups for Barcelona Clinic Liver Cancer (BCLC) stage A: 22.1 months (15.1–45.9) versus 30.9 months (19.6–46.8); p = 0.243); stage B: 18.4 months (11.2–19.4) versus 22.8 months (10.9–34.2); p = 0.815; and stage C: 8.8 months (7.1–10.8) versus 10.8 months (7.7–12.6); p = 0.976. Conclusions: Radioembolisation is a valuable treatment option for patients who relapse following surgical, ablative or vascular procedures and remain suitable candidates for this treatment.",
keywords = "Hepatocellular carcinoma, Radioembolisation, Selective internal radiation therapy, Yttrium-90 resin microspheres",
author = "{on behalf of the European Network on Radioembolization with Yttrium-90 resin microspheres (ENRY)} and Bruno Sangro and Maini, {Carlo Ludovico} and Ettorre, {Giuseppe Maria} and Roberto Cianni and Rita Golfieri and Daniele Gasparini and Samer Ezziddin and Paprottka, {Philipp M.} and Francesco Fiore and {van Buskirk}, Mark and Bilbao, {Jose Ignacio} and Rita Salvatori and Emanuela Giampalma and Onelio Geatti and Kai Wilhelm and Hoffmann, {Ralf Thorsten} and Francesco Izzo and Mercedes I{\~n}arrairaegui and Carlo Urigo and Alberta Cappelli and Alessandro Vit and Hojjat Ahmadzadehfar and Jakobs, {Tobias Franz} and Rosa Sciuto and Giuseppe Pizzi and Secondo Lastoria",
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AU - Maini, Carlo Ludovico

AU - Ettorre, Giuseppe Maria

AU - Cianni, Roberto

AU - Golfieri, Rita

AU - Gasparini, Daniele

AU - Ezziddin, Samer

AU - Paprottka, Philipp M.

AU - Fiore, Francesco

AU - van Buskirk, Mark

AU - Bilbao, Jose Ignacio

AU - Salvatori, Rita

AU - Giampalma, Emanuela

AU - Geatti, Onelio

AU - Wilhelm, Kai

AU - Hoffmann, Ralf Thorsten

AU - Izzo, Francesco

AU - Iñarrairaegui, Mercedes

AU - Urigo, Carlo

AU - Cappelli, Alberta

AU - Vit, Alessandro

AU - Ahmadzadehfar, Hojjat

AU - Jakobs, Tobias Franz

AU - Sciuto, Rosa

AU - Pizzi, Giuseppe

AU - Lastoria, Secondo

PY - 2018/3/7

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N2 - Purpose: Radioembolisation is part of the multimodal treatment of hepatocellular carcinoma (HCC) at specialist liver centres. This study analysed the impact of prior treatment on tolerability and survival following radioembolisation. Methods: This was a retrospective analysis of 325 consecutive patients with a confirmed diagnosis of HCC, who received radioembolisation with yttrium-90 resin microspheres at eight European centres between September 2003 and December 2009. The decision to treat was based on the clinical judgement of multidisciplinary teams. Patients were followed from the date of radioembolisation to last contact or death and the nature and severity of all adverse events (AEs) recorded from medical records. Results: Most radioembolisation candidates were Child-Pugh class A (82.5%) with multinodular HCC (75.9%) invading both lobes (53.1%); 56.3% were advanced stage. Radioembolisation was used first-line in 57.5% of patients and second-line in 34.2%. Common prior procedures were transarterial (chemo)embolisation therapies (27.1%), surgical resection/transplantation (17.2%) and ablation (8.6%). There was no difference in AE incidence and severity between prior treatment subgroups. Median (95% confidence interval [CI]) survival following radioembolisation was similar between procedure-naive and prior treatment groups for Barcelona Clinic Liver Cancer (BCLC) stage A: 22.1 months (15.1–45.9) versus 30.9 months (19.6–46.8); p = 0.243); stage B: 18.4 months (11.2–19.4) versus 22.8 months (10.9–34.2); p = 0.815; and stage C: 8.8 months (7.1–10.8) versus 10.8 months (7.7–12.6); p = 0.976. Conclusions: Radioembolisation is a valuable treatment option for patients who relapse following surgical, ablative or vascular procedures and remain suitable candidates for this treatment.

AB - Purpose: Radioembolisation is part of the multimodal treatment of hepatocellular carcinoma (HCC) at specialist liver centres. This study analysed the impact of prior treatment on tolerability and survival following radioembolisation. Methods: This was a retrospective analysis of 325 consecutive patients with a confirmed diagnosis of HCC, who received radioembolisation with yttrium-90 resin microspheres at eight European centres between September 2003 and December 2009. The decision to treat was based on the clinical judgement of multidisciplinary teams. Patients were followed from the date of radioembolisation to last contact or death and the nature and severity of all adverse events (AEs) recorded from medical records. Results: Most radioembolisation candidates were Child-Pugh class A (82.5%) with multinodular HCC (75.9%) invading both lobes (53.1%); 56.3% were advanced stage. Radioembolisation was used first-line in 57.5% of patients and second-line in 34.2%. Common prior procedures were transarterial (chemo)embolisation therapies (27.1%), surgical resection/transplantation (17.2%) and ablation (8.6%). There was no difference in AE incidence and severity between prior treatment subgroups. Median (95% confidence interval [CI]) survival following radioembolisation was similar between procedure-naive and prior treatment groups for Barcelona Clinic Liver Cancer (BCLC) stage A: 22.1 months (15.1–45.9) versus 30.9 months (19.6–46.8); p = 0.243); stage B: 18.4 months (11.2–19.4) versus 22.8 months (10.9–34.2); p = 0.815; and stage C: 8.8 months (7.1–10.8) versus 10.8 months (7.7–12.6); p = 0.976. Conclusions: Radioembolisation is a valuable treatment option for patients who relapse following surgical, ablative or vascular procedures and remain suitable candidates for this treatment.

KW - Hepatocellular carcinoma

KW - Radioembolisation

KW - Selective internal radiation therapy

KW - Yttrium-90 resin microspheres

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