PURPOSE: Patients with portal vein thrombosis (PVT) and hepatocellular carcinoma (HCC) have limited treatment options because of increased disease burden and diminished hepatic perfusion. Yttrium-90 ((90)Y) microspheres may be better tolerated than chemoembolization in these patients. The present study reviews the safety and efficacy of (90)Y microspheres in HCC with major PVT. MATERIALS AND METHODS: A retrospective review of HCC with main (n = 10) or first-branch (n = 12) PVT treated with (90)Y microspheres (N = 22) was conducted. Cancer of the Liver Italian Program (CLIP) scores ranged from 2 to 5, with 18% of patients having a score of 4 or greater. Imaging response at 8-12 was based on Response Evaluation Criteria In Solid Tumors. Overall survival (OS) was estimated by the Kaplan-Meier method. RESULTS: A total of 32 microsphere treatments (26 glass, six resin) were administered to 22 patients. Common grade 1/2 toxicities included abdominal pain (38%), nausea (28%), and fatigue (22%). Four posttreatment hospitalizations occurred, all less than 48 hours in duration. One death occurred 10 days after therapy. The partial response rate was 8% and progressive disease was seen in 42% of patients. Stable disease was achieved in 50% of treatments. Median OS was 7 months from initial treatment. Patients with Child-Pugh class A disease had a median OS of 7.7 months; those with class B/C disease had an OS of 2.7 months (P = .01). Median OS for patients with CLIP scores of 2/3 was 7 months, versus 1.3 months for those with scores of 4/5 (P = .04). CONCLUSIONS: Yttrium-90 microspheres are tolerated in patients with HCC and major PVT. Compared with chemoembolization, rates of severe adverse events appear low. Radiographic response rates are low. The median OS of 7 months is promising and warrants further study versus systemic therapy. Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.
PURPOSE:Patients with portal vein thrombosis (PVT) and hepatocellular carcinoma (HCC) have limited treatment options because of increased disease burden and diminished hepatic perfusion. Yttrium-90 ((90)Y) microspheres may be better tolerated than chemoembolization in these patients. The present study reviews the safety and efficacy of (90)Y microspheres in HCC with major PVT. MATERIALS AND METHODS: A retrospective review of HCC with main (n = 10) or first-branch (n = 12) PVT treated with (90)Y microspheres (N = 22) was conducted. Cancer of the Liver Italian Program (CLIP) scores ranged from 2 to 5, with 18% of patients having a score of 4 or greater. Imaging response at 8-12 was based on Response Evaluation Criteria In Solid Tumors. Overall survival (OS) was estimated by the Kaplan-Meier method. RESULTS: A total of 32 microsphere treatments (26 glass, six resin) were administered to 22 patients. Common grade 1/2 toxicities included abdominal pain (38%), nausea (28%), and fatigue (22%). Four posttreatment hospitalizations occurred, all less than 48 hours in duration. One death occurred 10 days after therapy. The partial response rate was 8% and progressive disease was seen in 42% of patients. Stable disease was achieved in 50% of treatments. Median OS was 7 months from initial treatment. Patients with Child-Pugh class A disease had a median OS of 7.7 months; those with class B/C disease had an OS of 2.7 months (P = .01). Median OS for patients with CLIP scores of 2/3 was 7 months, versus 1.3 months for those with scores of 4/5 (P = .04). CONCLUSIONS:Yttrium-90 microspheres are tolerated in patients with HCC and major PVT. Compared with chemoembolization, rates of severe adverse events appear low. Radiographic response rates are low. The median OS of 7 months is promising and warrants further study versus systemic therapy. Copyright 2010 SIR. Published by Elsevier Inc. All rights reserved.
Authors: P Therasse; S G Arbuck; E A Eisenhauer; J Wanders; R S Kaplan; L Rubinstein; J Verweij; M Van Glabbeke; A T van Oosterom; M C Christian; S G Gwyther Journal: J Natl Cancer Inst Date: 2000-02-02 Impact factor: 13.506
Authors: E Villa; A Moles; I Ferretti; P Buttafoco; A Grottola; M Del Buono; M De Santis; F Manenti Journal: Hepatology Date: 2000-08 Impact factor: 17.425
Authors: Douglas E Ramsey; Lily Y Kernagis; Michael C Soulen; Jean-Francois H Geschwind Journal: J Vasc Interv Radiol Date: 2002-09 Impact factor: 3.464
Authors: Riad Salem; Kenneth G Thurston; Brian I Carr; James E Goin; Jean-Francois H Geschwind Journal: J Vasc Interv Radiol Date: 2002-09 Impact factor: 3.464
Authors: Munveer Singh Bhangoo; Diraj R Karnani; Paul N Hein; Huan Giap; Harry Knowles; Chris Issa; Steve Steuterman; Paul Pockros; Catherine Frenette Journal: J Gastrointest Oncol Date: 2015-10
Authors: Ahmed O Kaseb; James L Abbruzzese; Jean-Nicolas Vauthey; Thomas A Aloia; Eddie K Abdalla; Manal M Hassan; E Lin; Lianchun Xiao; Adel S El-Deeb; Asif Rashid; Jeffrey S Morris Journal: Oncology Date: 2011-08-03 Impact factor: 2.935
Authors: Wong Hoi She; Tan To Cheung; Thomas C C Yau; Albert C Y Chan; Kenneth S H Chok; Ferdinand S K Chu; Rico K Y Liu; Ronnie T P Poon; See Ching Chan; Sheung Tat Fan; Chung Mau Lo Journal: Hepatobiliary Surg Nutr Date: 2014-08 Impact factor: 7.293