Analysis of Prognostic Factors After Yttrium-90 Radioembolization of Advanced Hepatocellular Carcinoma

Journal Article · Sun Aug 01 00:00:00 EDT 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.07.006· OSTI ID:21451145

Inarrairaegui, Mercedes ^[1]; Martinez-Cuesta, Antonio ^[2]; Rodriguez, Macarena ^[3]; Bilbao, J Ignacio ^[2]

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1. Liver Unit, Department of Internal Medicine, Clinica Universitaria de Navarrra, Pamplona (Spain)
2. Department of Interventional Radiology, Clinica Universitaria de Navarrra, Pamplona (Spain)
3. Department of Nuclear Medicine, Clinica Universitaria de Navarrra, Pamplona (Spain)

Purpose: To analyze which patient-, tumor-, and treatment-related factors may influence outcome after {sup 90}Y radioembolization ({sup 90}Y-RE) for hepatocellular carcinoma (HCC). Patients and Methods: Seventy-two consecutive patients with advanced HCC treated with {sup 90}Y-RE were studied to detect which factors may have influenced response to treatment and survival. Results: Median overall survival was 13 months (95% confidence interval, 9.6-16.3 months). In univariate analysis, survival was significantly better in patients with one to five lesions (19 vs. 8 months, p = 0.001) and in patients with alpha-fetoprotein <52 UI/mL (24 vs. 11 months, p = 0.002). The variation in target tumor size and the appearance of new lesions were analyzed among 50 patients with measurable tumors. A decrease in target tumor size was observed in most patients, and the intensity of such decrease was not associated with any of the factors under study. Patients who developed new lesions in the treated liver (and also in the nontargeted liver) at month 3 more frequently had more than five nodules, bilobar disease, and alpha-fetoprotein >52 UI/mL, and their survival in the multivariate analysis was significantly worse (hazard ratio, 4.7; 95% confidence interval, 13-1.73) (p = 0.002). Conclusions: Yttrium-90 radioembolization results in control of target lesions in the majority of patients with HCC but does not prevent the development of new lesions. Survival of patients treated with {sup 90}Y-RE seems to depend largely on factors related to the aggressiveness of the disease (number of nodules, levels of alpha-fetoprotein, and presence of microscopic disease).

• OSTI ID: 21451145
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 77, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2009.07.006; PII: S0360-3016(09)01033-5; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
EMBOLI
FORECASTING
HEPATOMAS
SURVIVAL CURVES
YTTRIUM 90
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
CARCINOMAS
DAYS LIVING RADIOISOTOPES
DISEASES
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
NEOPLASMS
NUCLEI
ODD-ODD NUCLEI
RADIOISOTOPES
YTTRIUM ISOTOPES