Joseph L McDevitt1, Ali Alian2, Baljendra Kapoor3, Stacy Bennett3, Amanjit Gill3, Abraham Levitin3, Mark Sands3, K V Narayanan Menon4, Federico N Aucejo5, Bassam Estfan6, Anil K Pillai7, Sanjeeva P Kalva7, Gordon McLennan3. 1. Department of Radiology, University of Texas Southwestern Medical Center, 5959 Harry Hines Boulevard, Dallas, TX 75235. Electronic address: josephlmcdevitt@icloud.com. 2. Department of Radiology, University of Texas Southwestern Medical Center, 5959 Harry Hines Boulevard, Dallas, TX 75235. 3. Vascular and Interventional Radiology, Cleveland Clinic, Cleveland, Ohio. 4. Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio. 5. Transplant Surgery, Cleveland Clinic, Cleveland, Ohio. 6. Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio. 7. Division of Vascular and Interventional Radiology, University of Texas Southwestern Medical Center, 5959 Harry Hines Boulevard, Dallas, TX 75235.
Abstract
PURPOSE: To compare overall survival and toxicities after yttrium-90 (90Y) radioembolization and chemoembolization with drug-eluting embolics (DEE) in patients with infiltrative hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Retrospective review of 50 patients with infiltrative HCC without main portal vein invasion who were treated with 90Y radioembolization (n = 26) or DEE chemoembolization (n = 24) between March 2007 and August 2012 was completed. Infiltrative tumors were defined by cross-sectional imaging as masses that lacked well-demarcated boundaries, and treatment allocations were made by a multidisciplinary tumor board. Median age was 63 years; median tumor diameter was 9.0 cm; and there were no significant differences between groups in performance status, severity of liver disease, or HCC stage. Toxicities were graded by Common Terminology Criteria for Adverse Events v4.03. Overall survival from treatment was assessed by Kaplan-Meier analysis, with analysis of potential predictors of survival with log-rank test. RESULTS: There was no difference in the average number of procedures performed in each treatment group (DEE, 1.5 ± 1.1; 90Y, 1.6 ± 0.5; P = .97), and technical success was achieved in all cases. Abdominal pain (73% vs 33%; P = .004) and fever (38% vs 8%; P = .01) were more frequent after DEE chemoembolization. There was no significant difference in median overall survival between treatment groups after treatment (DEE, 9.9 months; 90Y, 8.1 months; P = .11). CONCLUSIONS: 90Y radioembolization and DEE chemoembolization provided similar overall survival in the treatment of infiltrative HCC without main portal vein invasion. Abdominal pain and fever were more frequent after DEE chemoembolization.
PURPOSE: To compare overall survival and toxicities after yttrium-90 (90Y) radioembolization and chemoembolization with drug-eluting embolics (DEE) in patients with infiltrative hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Retrospective review of 50 patients with infiltrative HCC without main portal vein invasion who were treated with 90Y radioembolization (n = 26) or DEE chemoembolization (n = 24) between March 2007 and August 2012 was completed. Infiltrative tumors were defined by cross-sectional imaging as masses that lacked well-demarcated boundaries, and treatment allocations were made by a multidisciplinary tumor board. Median age was 63 years; median tumor diameter was 9.0 cm; and there were no significant differences between groups in performance status, severity of liver disease, or HCC stage. Toxicities were graded by Common Terminology Criteria for Adverse Events v4.03. Overall survival from treatment was assessed by Kaplan-Meier analysis, with analysis of potential predictors of survival with log-rank test. RESULTS: There was no difference in the average number of procedures performed in each treatment group (DEE, 1.5 ± 1.1; 90Y, 1.6 ± 0.5; P = .97), and technical success was achieved in all cases. Abdominal pain (73% vs 33%; P = .004) and fever (38% vs 8%; P = .01) were more frequent after DEE chemoembolization. There was no significant difference in median overall survival between treatment groups after treatment (DEE, 9.9 months; 90Y, 8.1 months; P = .11). CONCLUSIONS: 90Y radioembolization and DEE chemoembolization provided similar overall survival in the treatment of infiltrative HCC without main portal vein invasion. Abdominal pain and fever were more frequent after DEE chemoembolization.
Authors: Minseok Albert Kim; Heejoon Jang; Na Ryung Choi; Joon Yeul Nam; Yun Bin Lee; Eun Ju Cho; Jeong-Hoon Lee; Su Jong Yu; Hyo-Cheol Kim; Jin Wook Chung; Jung-Hwan Yoon; Yoon Jun Kim Journal: J Hepatocell Carcinoma Date: 2021-12-07