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Conference Paper: Radioembolization with yttrium-90 microspheres for inoperable advanced hepatocellular carcinoma (HCC)

TitleRadioembolization with yttrium-90 microspheres for inoperable advanced hepatocellular carcinoma (HCC)
Authors
Issue Date2013
PublisherHong Kong College of Radiologists.
Citation
The 5th Joint Scientific Meeting of The Royal College of Radiologists Hong Kong College of Radiologists and 21st Annual Scientific Meeting of Hong Kong College of Radiologists, Hong Kong, 2-3 November 2013. How to Cite?
AbstractObjective: Inoperable hepatocellular carcinoma (HCC) confers a grave prognosis. Radioembolization with yttrium-90 microspheres as selective internal radiation therapy (SIRT) was shown to a have favorable outcomes for HCC. We reported our series of patients with inoperable advanced HCC treated in a single institution. Materials and methods: Patients with inoperable HCC and evaluable target lesions were evaluated by hepatic angiography and macroalbumin aggregate (MAA) scan for feasibility for SIRT. Dose of yttrium-90 was decided by Body Surface Area (BSA) method with an aim to achieve dose to tumour ³200Gy and dose to normal liver <80Gy. Treatment outcomes including best local response rate, best local disease control rate, best overall objective response, disease control rate, progression-free survival (PFS), overall survival (OS) and toxicity were assessed. Univariate and multivariate analysis were also performed for any prognostic factors for PFS and OS. Results: 48 inoperable advanced HCC patients, majority of whom with tumour size ³8cm or portal vein invasion, were evaluated for SIRT. After pre-treatment hepatic angiography and macroalbumin aggregate (MAA) scan, 26 patients (54.2%) with a mean age of 61.6 years (range 36-84) were considered feasible and treated with SIRT and 24 patients had evaluable lesions for response assessment. Previous treatment for their HCC was performed in 15 patients (62.5%), including 11 patients (45.8%) who had received transarterial chemoembolization (TACE) before. Mean alpha-feto protein (AFP) was 1187.5ng/ml (range 2.0 to 10389.0 ng/ml). Mean radioactivity of yttrium-90 prescribed was 1.43 GBq (range 0.85 to 2.30 GBq). After a median follow up of 13.9 months, the best local response rate was 33.3% and the best local disease control rate was 54.2%. Median local PFS, overall PFS and OS survival was 3.3 months, 3.2 months and 11.6 months respectively. Patients belonging to Pugh-Child Class A enjoyed longer median OS survival (15.0 months) than those belonging to Pugh-Child B (4.3 months, p=0.014). Similarly, patients whose duration of AFP response ³9 months survived longer (median OS 19.9 months) than whose duration of AFP response <9 months (median OS 8.2 months, p=0.001). Four patients (16.7%) developed grade ³3 toxicity including 1 patient who had persistent radiation peptic ulcer requiring gastrectomy. Univariate analysis showed that radioactivity of yttrium-90 prescribed was prognostic of local progression-free survival (p=0.004), whereas portal vein invasion (p=0.018) and radioactivity of yttrium-90 prescribed (p=0.000) were prognostic of overall progression-free survival and radioactivity of yttrium-90 prescribed (p=0.005), portal vein invasion (p=0.021), dose to tumour (p=0.028) was prognostic factors of OS. Multivariate analysis revealed that duration of AFP response (p=0.011) was prognostic of overall progression-free survival and duration of AFP response (p=0.033) and Pugh-Child Class A (p=0.015) were prognostic of OS. Conclusion: SIRT with yttrium-90 microspheres for inoperable HCC patients produced promising treatment response.
Persistent Identifierhttp://hdl.handle.net/10722/194772

 

DC FieldValueLanguage
dc.contributor.authorLeung, DKCen_US
dc.contributor.authorLee, VHFen_US
dc.contributor.authorLiu, KYen_US
dc.contributor.authorLuk, MYen_US
dc.contributor.authorLaw, WMen_US
dc.contributor.authorTso, WKen_US
dc.contributor.authorWong, KKen_US
dc.contributor.authorWong, KKen_US
dc.contributor.authorMa, VWHen_US
dc.contributor.authorNg, CYen_US
dc.contributor.authorPoon, RTPen_US
dc.contributor.authorTong, CCen_US
dc.contributor.authorLeung, TWen_US
dc.date.accessioned2014-02-17T02:09:15Z-
dc.date.available2014-02-17T02:09:15Z-
dc.date.issued2013en_US
dc.identifier.citationThe 5th Joint Scientific Meeting of The Royal College of Radiologists Hong Kong College of Radiologists and 21st Annual Scientific Meeting of Hong Kong College of Radiologists, Hong Kong, 2-3 November 2013.en_US
dc.identifier.urihttp://hdl.handle.net/10722/194772-
dc.description.abstractObjective: Inoperable hepatocellular carcinoma (HCC) confers a grave prognosis. Radioembolization with yttrium-90 microspheres as selective internal radiation therapy (SIRT) was shown to a have favorable outcomes for HCC. We reported our series of patients with inoperable advanced HCC treated in a single institution. Materials and methods: Patients with inoperable HCC and evaluable target lesions were evaluated by hepatic angiography and macroalbumin aggregate (MAA) scan for feasibility for SIRT. Dose of yttrium-90 was decided by Body Surface Area (BSA) method with an aim to achieve dose to tumour ³200Gy and dose to normal liver <80Gy. Treatment outcomes including best local response rate, best local disease control rate, best overall objective response, disease control rate, progression-free survival (PFS), overall survival (OS) and toxicity were assessed. Univariate and multivariate analysis were also performed for any prognostic factors for PFS and OS. Results: 48 inoperable advanced HCC patients, majority of whom with tumour size ³8cm or portal vein invasion, were evaluated for SIRT. After pre-treatment hepatic angiography and macroalbumin aggregate (MAA) scan, 26 patients (54.2%) with a mean age of 61.6 years (range 36-84) were considered feasible and treated with SIRT and 24 patients had evaluable lesions for response assessment. Previous treatment for their HCC was performed in 15 patients (62.5%), including 11 patients (45.8%) who had received transarterial chemoembolization (TACE) before. Mean alpha-feto protein (AFP) was 1187.5ng/ml (range 2.0 to 10389.0 ng/ml). Mean radioactivity of yttrium-90 prescribed was 1.43 GBq (range 0.85 to 2.30 GBq). After a median follow up of 13.9 months, the best local response rate was 33.3% and the best local disease control rate was 54.2%. Median local PFS, overall PFS and OS survival was 3.3 months, 3.2 months and 11.6 months respectively. Patients belonging to Pugh-Child Class A enjoyed longer median OS survival (15.0 months) than those belonging to Pugh-Child B (4.3 months, p=0.014). Similarly, patients whose duration of AFP response ³9 months survived longer (median OS 19.9 months) than whose duration of AFP response <9 months (median OS 8.2 months, p=0.001). Four patients (16.7%) developed grade ³3 toxicity including 1 patient who had persistent radiation peptic ulcer requiring gastrectomy. Univariate analysis showed that radioactivity of yttrium-90 prescribed was prognostic of local progression-free survival (p=0.004), whereas portal vein invasion (p=0.018) and radioactivity of yttrium-90 prescribed (p=0.000) were prognostic of overall progression-free survival and radioactivity of yttrium-90 prescribed (p=0.005), portal vein invasion (p=0.021), dose to tumour (p=0.028) was prognostic factors of OS. Multivariate analysis revealed that duration of AFP response (p=0.011) was prognostic of overall progression-free survival and duration of AFP response (p=0.033) and Pugh-Child Class A (p=0.015) were prognostic of OS. Conclusion: SIRT with yttrium-90 microspheres for inoperable HCC patients produced promising treatment response.en_US
dc.languageengen_US
dc.publisherHong Kong College of Radiologists.en_US
dc.relation.ispartof21st Annual Scientific Meeting of Hong Kong College of Radiologists 2013en_US
dc.titleRadioembolization with yttrium-90 microspheres for inoperable advanced hepatocellular carcinoma (HCC)en_US
dc.typeConference_Paperen_US
dc.identifier.emailLee, VHF: vhflee@hku.hken_US
dc.identifier.emailLiu, KY: ricoliu@hkucc.hku.hken_US
dc.identifier.emailLuk, MY: myluk@hkucc.hku.hken_US
dc.identifier.emailWong, KK: nmkkwong@hkucc.hku.hken_US
dc.identifier.emailNg, CY: ngchoryi@hku.hken_US
dc.identifier.emailPoon, RTP: poontp@hku.hken_US
dc.identifier.emailTong, CC: tccz01@hku.hken_US
dc.identifier.emailLeung, TW: ltw920@hkucc.hku.hken_US
dc.identifier.authorityLee, VHF=rp00264en_US
dc.identifier.authorityPoon, RTP=rp00446en_US
dc.identifier.hkuros227942en_US
dc.publisher.placeHong Kongen_US

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