DOI: 10.1007/s00259-018-3968-5Pages: 1721-1730

Radioembolisation in patients with hepatocellular carcinoma that have previously received liver-directed therapies

1. Clinica Universidad de Navarra, and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Liver Unit

2. IFO Regina Elena National Cancer Institute, Nuclear Medicine

3. San Camillo Hospital, General Surgery and Transplantation Unit

4. Ospedale S.M.Goretti, Interventional Radiology

5. Azienda Ospedaliero Universitaria di Bologna

6. Azienda Ospedaliera S. M. della Misericordia, Diagnostic and Interventional Radiology

7. Universitätsklinik Bonn, Nuclear Medicine

8. LMU Klinikum der Universität München, Interventional Radiology

9. Istituto Tumori Pascale, Onco Interventional Radiology

10. Data Reduction LLC

11. Clinica Universidad de Navarra, Interventional Radiology

12. Ospedale S.M.Goretti, Nuclear Medicine

13. Azienda Ospedaliera S. M. della Misericordia, Nuclear Medicine

14. University of Bonn, Department of Radiology

15. Istituto Tumori Pascale, Hepatobiliary Surgery

16. S. Orsola-Malpighi Hospital, Medical Oncology

17. IFO Regina Elena National Cancer Institute, Interventional Radiology

18. Istituto Tumori Pascale, Nuclear Medicine

Correspondence to:
Bruno Sangro
Tel: +34-948-296637
Email: bsangro@unav.es

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Abstract

Purpose

Radioembolisation is part of the multimodal treatment of hepatocellular carcinoma (HCC) at specialist liver centres. This study analysed the impact of prior treatment on tolerability and survival following radioembolisation.

Methods

This was a retrospective analysis of 325 consecutive patients with a confirmed diagnosis of HCC, who received radioembolisation with yttrium-90 resin microspheres at eight European centres between September 2003 and December 2009. The decision to treat was based on the clinical judgement of multidisciplinary teams. Patients were followed from the date of radioembolisation to last contact or death and the nature and severity of all adverse events (AEs) recorded from medical records.

Results

Most radioembolisation candidates were Child-Pugh class A (82.5%) with multinodular HCC (75.9%) invading both lobes (53.1%); 56.3% were advanced stage. Radioembolisation was used first-line in 57.5% of patients and second-line in 34.2%. Common prior procedures were transarterial (chemo)embolisation therapies (27.1%), surgical resection/transplantation (17.2%) and ablation (8.6%). There was no difference in AE incidence and severity between prior treatment subgroups. Median (95% confidence interval [CI]) survival following radioembolisation was similar between procedure-naive and prior treatment groups for Barcelona Clinic Liver Cancer (BCLC) stage A: 22.1 months (15.1–45.9) versus 30.9 months (19.6–46.8); p = 0.243); stage B: 18.4 months (11.2–19.4) versus 22.8 months (10.9–34.2); p = 0.815; and stage C: 8.8 months (7.1–10.8) versus 10.8 months (7.7–12.6); p = 0.976.

Conclusions

Radioembolisation is a valuable treatment option for patients who relapse following surgical, ablative or vascular procedures and remain suitable candidates for this treatment.

This article is freely available, click here to access the full text/PDF

  • Accepted: Feb 1, 2018
  • Online: Mar 7, 2018

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