Safety and Efficacy of Transarterial Radioembolisation in Patients with Intermediate or Advanced Stage Hepatocellular Carcinoma Refractory to Chemoembolisation

Journal Article · Fri Dec 15 04:00:00 EST 2017 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-017-1739-5· OSTI ID:22756316

Klompenhouwer, Elisabeth G.; Dresen, Raphaëla C. ^[1]; Verslype, Chris ^[2]; Laenen, Annouschka ^[3]; Hertogh, Gert De ^[4]; Deroose, Christophe M. ^[5]; Bonne, Lawrence; Vandevaveye, Vincent; Maleux, Geert ^[1]

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1. University Hospitals Leuven, Department of Radiology (Belgium)
2. University Hospitals Leuven, Department of Digestive Oncology (Belgium)
3. KU Leuven Universiteit Hasselt, Department of Biostatistics and Statistical Bioinformatics (Belgium)
4. University Hospitals Leuven, Department of Pathology (Belgium)
5. University Hospitals Leuven, Nuclear Medicine (Belgium)

IntroductionTransarterial chemoembolisation (TACE) is the most widely used locoregional treatment for patients with an unresectable hepatocellular carcinoma (HCC). Transarterial radioembolisation (TARE) with yttrium-90 containing microspheres is an emerging interventional treatment that could be complementary or an alternative to TACE.AimTo evaluate the safety and efficacy of TARE in patients with HCC who are refractory to TACE with drug-eluting beads (DEB-TACE).MethodsWe identified all patients who received TARE for HCC following one or more sessions of DEB-TACE in the period 2007–2016. Grade ≥3 adverse events were graded according to Common Terminology Criteria for Adverse events. Response on MRI was determined on MRI by modified RECIST. Overall survival was estimated using the Kaplan–Meier method and was determined from the first TACE and from the TARE procedure.ResultsA total of 30 patients were included. Patients had a mean of 1.7 TACE procedures (range 1–4) prior to TARE. Grade 3 adverse events following TARE included: fatigue (20%), bilirubin increase (10%), cholecystitis (3.3%) and a gastric ulcer (3.3%). Response on MRI was achieved in 36.7%. Three patients (10%) were downstaged within the Milan criteria and received liver transplantation. The median overall survival after first TACE was 32.3 months (17.2–42.1 95% CI). The median overall survival after TARE was 14.8 months (8.33–26.5 95% CI).ConclusionTARE is safe and can be effective in patients with an intermediate or advanced stage HCC who are refractory to TACE. This treatment strategy has the potential to downstage to liver transplantation.

• OSTI ID: 22756316
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 12 Vol. 40; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
HEPATOMAS
NMR IMAGING
PATIENTS
RADIOEMBOLIZATION
REFRACTORIES
YTTRIUM 90