钇90放射栓塞治疗的乙型肝炎肝细胞癌患者的毒性和生存期：

StephenW

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.

Copyright © 2019 SIR. Published by Elsevier Inc. All rights reserved.

PMID:
    31983593
DOI:
    10.1016/j.jvir.2019.08.033

StephenW

J Vasc互动无线电。 2020年1月23日。pii：S1051-0443（19）30808-5。土井：10.1016 / j.jvir.2019.08.033。 [Epub提前发行]
钇90放射栓塞治疗的乙型肝炎肝细胞癌患者的毒性和生存期：更新的15年研究。
高R1，加布A1，穆里S1，里亚兹A1，库里克L2，勒万多夫斯基RJ1，塞勒姆R3。
作者信息

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]。

抽象
目的：

为了评估Yttrium-90经动脉放射栓塞（TARE）治疗15年后继发于乙型肝炎病毒（HBV）感染的肝细胞癌（HCC）的毒性和存活率。
材料和方法：

这项研究回顾性分析了93例连续的HBV HCC患者，这些患者全部来自最初的1000例患者。他们在2003年12月至2018年12月之间通过标准放射线段切除术/肺叶切除术接受了TARE治疗。该组包括80例男性和13例女性，其中79例仅具有HBV，14个具有其他肝合并症。毒性等级由“不良事件通用术语标准” 5.0版确定。使用意向性治疗（ITT），审查或竞争风险报告了总生存期（OS）。单变量/多变量分析用于评估OS的预测因子。
结果：

治疗后3/4级的毒性包括白蛋白（1.1％），胆红素（4.3％），天冬氨酸转氨酶（6.5％）和丙氨酸转氨酶（3.2％）。被检查的OS的中位数为16.9个月（95％置信区间[CI]，11.8 -23.5）：Child-Pugh（CP）A为17.5个月（95％CI，11.5-86.9）和14.5个月（95％CI，5.2-22.5） ）对于CP B；巴塞罗那临床肝癌（BCLC）A，B和C分别未达到16.9个月（95％CI，11.2 -68.7）和11.5个月（95％CI，8.6-17.5）。多变量分析显示，将治愈性治疗指定为竞争性风险时，白蛋白，甲胎蛋白和门静脉血栓形成是ITT OS的独立预测因子，白蛋白和肿瘤大小是预测因子。
结论：

这项回顾性研究表明，TARE治疗对HBV衍生的HCC患者的毒性最小。与CP B和BCLC B / C疾病患者相比，CP A或BCLC A疾病患者具有更好的生存结局。这些提示表明，对于某些继发于HBV感染的HCC肿瘤的患者群体，TARE是一种可行的治疗选择。

版权所有©2019 SIR。由Elsevier Inc.出版。保留所有权利。

PMID：
31983593
DOI：
10.1016 / j.jvir.2019.08.033