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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 (RCR) & Hong Kong College of Radiologists (HKCR) and 21st Annual Scientific Meeting of HKCR, 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 (RCR) & Hong Kong College of Radiologists (HKCR) and 21st Annual Scientific Meeting of HKCR, 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.ispartofRCR / HKCR Joint Scientific Meeting & HKCR ASM 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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