J Vasc Interv Radiol. 2020 Jan 23. pii: S1051-0443(19)30808-5. doi: 10.1016/j.jvir.2019.08.033. [Epub ahead of print]
Toxicity and Survival of Hepatocellular Carcinoma Patients with Hepatitis B Infection Treated with Yttrium-90 Radioembolization: An Updated 15-Year Study.
Gao R1, Gabr A1, Mouli S1, Riaz A1, Kulik L2, Lewandowski RJ1, Salem R3.
Author information
1
Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N St Clair, Suite 800, Chicago, IL, 60611.
2
Department of Medicine, Northwestern University Feinberg School of Medicine, 676 N St Clair, Suite 800, Chicago, IL, 60611.
3
Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N St Clair, Suite 800, Chicago, IL, 60611. Electronic address: [email protected].
Abstract
PURPOSE:
To evaluate the toxicity and survival of hepatocellular carcinoma (HCC) secondary to hepatitis B virus (HBV) infection treated with yttrium-90 transarterial radioembolization (TARE) over a 15-year period.
MATERIALS AND METHODS:
This study retrospectively analyzed 93 consecutive patients with HBV HCC-all derived from an original cohort of 1,000 patients-who were treated with TARE via standard radiation segmentectomy/lobectomy between December 2003 and December 2018. This group comprised 80 males and 13 females, with 79 having only HBV and 14 having additional liver comorbidities. Toxicity grades were determined by Common Terminology Criteria for Adverse Events, version 5.0. Overall survival (OS) was reported using intention-to-treat (ITT), censored, or competing risk. Univariate/multivariate analyses were used to evaluate predictors of OS.
RESULTS:
Posttreatment grade 3/4 toxicities included albumin (1.1%), bilirubin (4.3%), aspartate transaminase (6.5%), and alanine transaminase (3.2%). Median censored OS was 16.9 months (95% confidence interval [CI], 11.8-23.5): 17.5 months (95% CI, 11.5-86.9) for Child-Pugh (CP) A and 14.5 months (95% CI, 5.2-22.5) for CP B; not reached, 16.9 months (95% CI, 11.2-68.7), and 11.5 months (95% CI, 8.6-17.5) for Barcelona Clinic Liver Cancer (BCLC) A, B, and C, respectively. Multivariate analysis revealed albumin, alpha-fetoprotein, and portal vein thrombosis as independent predictors of ITT OS and albumin and tumor size as predictors when curative therapy was assigned as a competing risk.
CONCLUSIONS:
This retrospective study showed that TARE therapy resulted in minimal toxicity in patients with HBV-derived HCC. Patients with CP A or BCLC A disease had superior survival outcomes compared to patients with CP B and BCLC B/C disease. These findings suggest that TARE is a viable treatment option for certain patient groups with HCC tumors secondary to HBV infection.
1个
西北大学Feinberg医学院放射系，676 N St Clair，Suite 800，IL，Chicago，60611。
2
西北大学Feinberg医学院医学系，676 N St Clair，Suite 800，Chicago，IL，60611。
3
西北大学芬伯格医学院放射系，伊利诺伊州芝加哥市N街克莱尔676号，套房800，邮编60611。电子地址：[email protected]。