Efficacy and Safety of Transarterial Radioembolization Versus Chemoembolization in Patients With Hepatocellular Carcinoma

Journal Article · Sat Jun 15 00:00:00 EDT 2013 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-012-0481-2· OSTI ID:22113655

Yang, Ju Dong; Sanchez, William ^[1]; Paz-Fumagalli, Ricardo ^[2]; Harnois, Denise M.; Mettler, Teresa A. ^[1]; Gansen, Denise N. ^[2]; Groen, Piet C. de; Lazaridis, Konstantinos N.; Narayanan Menon, K. V.; LaRusso, Nicholas F. ^[1]; Alberts, Steven R. ^[3]; Gores, Gregory J. ^[1]; Fleming, Chad J. ^[2]; Slettedahl, Seth W.; Harmsen, William S.; Therneau, Terry M. ^[4]; Wiseman, Gregory A.; Andrews, James C. ^[2]

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1. College of Medicine, Mayo Clinic, Division of Gastroenterology and Hepatology (United States)
2. College of Medicine, Mayo Clinic, Department of Radiology (United States)
3. College of Medicine, Mayo Clinic and Mayo Clinic Cancer Center, Department of Oncology (United States)
4. College of Medicine, Mayo Clinic, Department of Health Sciences Research (United States)

Purpose. Intermediate-stage hepatocellular carcinoma (HCC) is usually treated with locoregional therapy using transarterial chemoembolization (TACE). Transarterial radioembolization (TARE) using {beta}-emitting yttrium-90 integral to the glass matrix of the microspheres is an alternative to TACE. This retrospective case-control study compared the outcomes and safety of TARE versus TACE in patients with unresectable HCC. Materials and Methods. Patients with unresectable HCC without portal vein thrombosis treated with TARE between 2005 and 2008 (n = 61) were retrospectively frequency-matched by age, sex, and liver dysfunction with TACE-treated patients (n = 55) in the Mayo Clinic Hepatobiliary Neoplasia Registry. Imaging studies were reviewed, and clinical and safety outcomes were abstracted from the medical records. Results. Complete tumor response was more common after TARE (12 %) than after TACE (4 %) (p = 0.17). When complete response was combined with partial response and stable disease, there was no difference between TARE and TACE. Median survival did not differ between the two groups (15.0 months for TARE and 14.4 months for TACE; p = 0.47). Two-year survival rates were 30 % for TARE and 24 % for TACE. TARE patients received fewer treatments (p < 0.001). Fifty-nine (97 %) TARE patients received outpatient treatment. In contrast, 53 (98 %) TACE patients were hospitalized for {>=}1 day (p < 0.001). Compared with TACE, TARE was more likely to induce fatigue (p = 0.003) but less likely to cause fever (p = 0.02). Conclusion. There was no significant difference in efficacy between TARE and TACE. TARE patients reported more fatigue but had less fever than TACE patients. Treatment with TARE required less hospitalization than treatment with TACE. These findings require confirmation in randomized trials.

• OSTI ID: 22113655
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 36, Issue 3; Other Information: Copyright (c) 2013 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRACHYTHERAPY
FATIGUE
FEVER
HEPATOMAS
LIVER
PATIENTS
THROMBOSIS
VEINS
YTTRIUM 90