Randomized Comparison of Selective Internal Radiotherapy (SIRT) Versus Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE) for the Treatment of Hepatocellular Carcinoma

Journal Article · Wed Apr 15 04:00:00 EDT 2015 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-014-1012-0· OSTI ID:22470030

Kloeckner, Roman ^[1]; Ruckes, Christian ^[2]; Wirth, Gesine M. ^[1]; Eichhorn, Waltraud ^[3]; Wörns, Marcus A.; Weinmann, Arndt ^[4]; Schreckenberger, Mathias ^[3]; Galle, Peter R. ^[4]; Otto, Gerd ^[5]; Dueber, Christoph ^[1]

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1. Johannes Gutenberg University Medical Center, Department of Diagnostic and Interventional Radiology (Germany)
2. Johannes Gutenberg University Medical Center, IZKS (Germany)
3. Johannes Gutenberg University Medical Center, Department of Nuclear Medicine (Germany)
4. Johannes Gutenberg University Medical Center, Department of Internal Medicine (Germany)
5. Johannes Gutenberg University Medical Center, Department of Transplantation Surgery (Germany)

PurposeTo prospectively compare SIRT and DEB-TACE for treating hepatocellular carcinoma (HCC).MethodsFrom 04/2010–07/2012, 24 patients with histologically proven unresectable N0, M0 HCCs were randomized 1:1 to receive SIRT or DEB-TACE. SIRT could be repeated once in case of recurrence; while, TACE was repeated every 6 weeks until no viable tumor tissue was detected by MRI or contraindications prohibited further treatment. Patients were followed-up by MRI every 3 months; the final evaluation was 05/2013.ResultsBoth groups were comparable in demographics (SIRT: 8males/4females, mean age 72 ± 7 years; TACE: 10males/2females, mean age 71 ± 9 years), initial tumor load (1 patient ≥25 % in each group), and BCLC (Barcelona Clinic Liver Cancer) stage (SIRT: 12×B; TACE 1×A, 11×B). Median progression-free survival (PFS) was 180 days for SIRT versus 216 days for TACE patients (p = 0.6193) with a median TTP of 371 days versus 336 days, respectively (p = 0.5764). Median OS was 592 days for SIRT versus 788 days for TACE patients (p = 0.9271). Seven patients died in each group. Causes of death were liver failure (n = 4 SIRT group), tumor progression (n = 4 TACE group), cardiovascular events, and inconclusive (n = 1 in each group).ConclusionsNo significant differences were found in median PFS, OS, and TTP. The lower rate of tumor progression in the SIRT group was nullified by a greater incidence of liver failure. This pilot study is the first prospective randomized trial comparing SIRT and TACE for treating HCC, and results can be used for sample size calculations of future studies.

• OSTI ID: 22470030
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 2 Vol. 38; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANIMAL TISSUES
COMPARATIVE EVALUATIONS
DEATH
DRUGS
FAILURES
HEPATOMAS
LIVER
NMR IMAGING
PATIENTS
RADIOTHERAPY