Therapeutic equivalence in survival for hepatic arterial chemoembolization and yttrium 90 microsphere treatments in unresectable hepatocellular carcinoma: A two-cohort study

Brian I. Carr, Venkateswarlu Kondragunta, Shama C. Buch, Robert A. Branch

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Intrahepatic arterial yttrium 90 (90Y) microspheres have been proposed as a less toxic, less invasive therapeutic option to transhepatic arterial chemoembolization (TACE) for patients with surgically unresectable hepatocellular carcinoma (HCC). TACE has demonstrated the ability to prolong survival. However, long-term survival remains uncertain. METHODS: In a 2-cohort experience in the treatment of North American patients who had advanced, unresectable, biopsy-proven HCC, 691 patients received repetitive, cisplatin-based chemoembolization; and a separate cohort of 99 patients who had similar treatment criteria received a planned, single dose of 90Y. Over the study period, an additional 142 patients were followed without treatment (total, 932 patients). RESULTS: Overall survival was slightly better in the 90Y group compared with the TACE group (median survival, 11.5 months vs 8.5 months). However, the selection criteria indicated a small but significant bias toward milder disease in the 90Y group. By using stratification into a 3-tier model with patients dichotomized according to bilirubin levels 90Y and TACE appeared to be equivalent regional therapies for patients with unresectable, nonmetastatic HCC.

Original languageEnglish
Pages (from-to)1305-1314
Number of pages10
JournalCancer
Volume116
Issue number5
DOIs
Publication statusPublished - Mar 1 2010

Keywords

  • Chemotherapy
  • Hepatocellular carcinoma
  • Hepatoma
  • Internal radiation
  • Yttrium

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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