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

127 Citations (Scopus)

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

Fingerprint

Yttrium
Microspheres
Hepatocellular Carcinoma
Cohort Studies
Survival
Liver
Therapeutics
Poisons
Bilirubin
Patient Selection
Cisplatin
Biopsy

Keywords

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

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Therapeutic equivalence in survival for hepatic arterial chemoembolization and yttrium 90 microsphere treatments in unresectable hepatocellular carcinoma : A two-cohort study. / Carr, Brian I.; Kondragunta, Venkateswarlu; Buch, Shama C.; Branch, Robert A.

In: Cancer, Vol. 116, No. 5, 01.03.2010, p. 1305-1314.

Research output: Contribution to journalArticle

Carr, Brian I. ; Kondragunta, Venkateswarlu ; Buch, Shama C. ; Branch, Robert A. / Therapeutic equivalence in survival for hepatic arterial chemoembolization and yttrium 90 microsphere treatments in unresectable hepatocellular carcinoma : A two-cohort study. In: Cancer. 2010 ; Vol. 116, No. 5. pp. 1305-1314.
@article{627685f7f76547588a89020d050731a2,
title = "Therapeutic equivalence in survival for hepatic arterial chemoembolization and yttrium 90 microsphere treatments in unresectable hepatocellular carcinoma: A two-cohort study",
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.",
keywords = "Chemotherapy, Hepatocellular carcinoma, Hepatoma, Internal radiation, Yttrium",
author = "Carr, {Brian I.} and Venkateswarlu Kondragunta and Buch, {Shama C.} and Branch, {Robert A.}",
year = "2010",
month = "3",
day = "1",
doi = "10.1002/cncr.24884",
language = "English",
volume = "116",
pages = "1305--1314",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "5",

}

TY - JOUR

T1 - Therapeutic equivalence in survival for hepatic arterial chemoembolization and yttrium 90 microsphere treatments in unresectable hepatocellular carcinoma

T2 - A two-cohort study

AU - Carr, Brian I.

AU - Kondragunta, Venkateswarlu

AU - Buch, Shama C.

AU - Branch, Robert A.

PY - 2010/3/1

Y1 - 2010/3/1

N2 - 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.

AB - 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.

KW - Chemotherapy

KW - Hepatocellular carcinoma

KW - Hepatoma

KW - Internal radiation

KW - Yttrium

UR - http://www.scopus.com/inward/record.url?scp=77149134647&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77149134647&partnerID=8YFLogxK

U2 - 10.1002/cncr.24884

DO - 10.1002/cncr.24884

M3 - Article

C2 - 20066715

AN - SCOPUS:77149134647

VL - 116

SP - 1305

EP - 1314

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 5

ER -