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

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)1721-1730
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume45
Issue number10
DOIs
Publication statusPublished - Sep 2018

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Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular/radiotherapy
  • Embolization, Therapeutic/adverse effects
  • Female
  • Humans
  • Liver/radiation effects
  • Liver Neoplasms/radiotherapy
  • Male
  • Middle Aged
  • Retrospective Studies
  • Safety
  • Survival Analysis
  • Young Adult

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