Abstract
BackgroundThis retrospective analysis was undertaken to evaluate the efficiency of SIRT with Y-90 microspheres and determined prognostic factors affecting patients with unresectable HCC.MethodsA total of 97 patients diagnosed with unresectable HCC who underwent SIRT with Y-90 microspheres. Patient survival was assessed using the Kaplan–Meier method, and prognostic factors affecting survival were assessed using log-rank tests and Cox proportional hazards regression.ResultsAmong the 97 patients (90 males, mean age 60.4 ± 12.3 years) who underwent SIRT, the median clinical follow-up was 16.4 (1.8–62) months. The median overall survival (OS) was 23.9 ± 2.4 months. Tumor response according to the Modified RECIST in patients followed up beyond 6 months included a complete response (CR) to treatment in 12 patients (18.8%), partial response (PR) in 23 (35.8%), stable disease (SD) in 8 (12.5%), and progressive disease (PD) in 21 (32.8%). Factors associated with longer OS included age > 65 years, BCLC stage B, tumor size < 5 cm, tumor burden < 25%, and tumor response (CR/PR). In multivariate analysis, unilobar disease and objective tumor response (CR/PR) were predictors of longer OS.ConclusionSIRT was an effective treatment for unresectable HCC. Unilobar disease before SIRT and tumor response (CR/PR) were positive prognostic factors.
Highlights
Hepatocellular carcinoma (HCC) is the most common primary liver cancer
Only 20–30% of HCC patients are diagnosed at an early stage; most (> 70%) patients are diagnosed with unresectable disease and have poor overall prognosis [2]
Starting in October 2013, all consecutive patients with HCC who were unsuitable for radical treatments or chemoembolization as a result of the presence of portal vein thrombosis (PVT) or extensive tumor burden were assessed for Selective internal radiation therapy (SIRT)
Summary
Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Worldwide, liver cancers are the fourth most common cause of cancer-related deaths.Based on annual projections, the World Health Organization estimates that more than 1 million patients will die from liver cancer in 2030. Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Liver cancers are the fourth most common cause of cancer-related deaths. The World Health Organization estimates that more than 1 million patients will die from liver cancer in 2030. Only 20–30% of HCC patients are diagnosed at an early stage; most (> 70%) patients are diagnosed with unresectable disease and have poor overall prognosis [2]. Radical therapies, including resection or transplantation, are the gold standard for early-stage HCC [3]. This retrospective analysis was undertaken to evaluate the efficiency of SIRT with Y-90 microspheres and determined prognostic factors affecting patients with unresectable HCC
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