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Conference Paper: Treatment Outcomes of Patients with Extremely Advanced Inoperable Hepatocellular Carcinoma (HCC) After Yttrium-90 Radioembolization

TitleTreatment Outcomes of Patients with Extremely Advanced Inoperable Hepatocellular Carcinoma (HCC) After Yttrium-90 Radioembolization
Authors
Issue Date2014
PublisherOxford University Press. The Journal's web site is located at http://annonc.oxfordjournals.org/
Citation
The European Society for Medical Oncology (ESMO) 16th World Congress on Gastrointestinal Cancer, Barcelona, Spain, 25–28 June 2014. In Annals of Oncology, 2014, v. 25 n. Suppl. 2, p. ii41-ii42, abstract no. P-0093 How to Cite?
AbstractIntroduction: Inoperable hepatocellular carcinoma (HCC) confers a grave prognosis especially those exhibiting portal vein invasion. Radioembolization with yttrium-90 microspheres as selective internal radiation therapy demonstrated favorable outcomes for this intractable disease.We reported our series of patients with extremely advanced unresectable HCC treated with yttrium-90 micospheres. Methods: Patients with extremely advanced inoperable and evaluable HCC including those with single lesion >8cm in maximal diameter or multiple bi-lobar lesions (total >5 lesions) or portal vein invasion were evaluated by hepatic angiography and macroalbumin aggregate (MAA) scan for feasiblity for radioembolization. Dose of yttrium-90 was determined by Body Surface Area (BSA) method with an aim to achieve dose to tumour >200Gy, dose to normal liver <80Gy and lung shunting <10%. Treatment outcomes including best local response rate, best local disease control rate, progression-free survival (PFS), overall survival (OS) and toxicity were assessed. Univariate and multivariate analysis were also performed any prognostic factors for survival. Results: After pre-treatment hepatic angiography and MAA scan, 28 patients with a median age of 63.0 years (range 36-84) were considered feasible for SIRT. All patients have evaluable lesions for response assessment. Prior treatment before radioembolization was performed in 17 patients (60.7%), including 14 patients (50.0%) who had received transarterial chemoembolization (TACE) before. Mean alpha-feto protein (AFP was 19.5 ng/ml (range 1.0 to 10389.0 ng/ml). Median radioactivity of yttrium-90 prescribed was 1.48 GBq (range 0.85 to 2.30 GBq). After a median follow up of 16.2 months, the best local response rate was 21.4% and the best local disease control rate was 39.3%. Median overall PFS and OS were 3.25 months and 11.5 months respectively. Longer median PFS was noted in those who had prior TACE before radioembolization (7.3 vs. 3.1 months, p = 0.035), duration of AFP response >6 months (11.8 vs. 3.1 months, p = 0.020) and whose tumour had absence of portal vein invasion (4.5 vs. 3.1 months, p = 0.057). Longer median OS were also revealed in those without portal vein invasion (17.1 vs. 4.4 months, p = 0.020) and those whose duration of AFP response >6 months (19.8 vs. 8.2 months, p = 0.008). Four patients (14.3%) developed grade 3 or above toxicity including 1 patient who had persistent radiation peptic ulcer requiring gastrectomy. Univariate analysis showed that prior TACE (p = 0.043) and duration of AFP response >6 months were prognostic of PFS, whereas absence of portal vein invasion (p = 0.027) and duration of AFP response >6 months (p = 0.017) were prognostic factors of OS. Multivariate analysis revealed that prior TACE (p = 0.041) and duration of AFP response >6 months (p = 0.001) were prognostic of both PFS while absence of portal vein invasion (p = 0.050) and duration of AFP response >6 months (p = 0.005) were prognostic of OS. Conclusion: Ytrrium-90 radioembolization was able to produce promising treatment outcomes even in extremely advanced HCC. Absence of portal vein invasion and long AFP response were favorable prognostic factors for OS.
DescriptionPoster Presentation
Persistent Identifierhttp://hdl.handle.net/10722/203990
ISSN
2015 Impact Factor: 9.269
2015 SCImago Journal Rankings: 4.362

 

DC FieldValueLanguage
dc.contributor.authorLee, VHFen_US
dc.contributor.authorLeung, Den_US
dc.contributor.authorLuk, MYen_US
dc.contributor.authorTong, CCen_US
dc.contributor.authorLaw, WMen_US
dc.contributor.authorNg, CYen_US
dc.contributor.authorTso, WKen_US
dc.contributor.authorMa, WHen_US
dc.contributor.authorLiu, KYen_US
dc.contributor.authorKwong, DLWen_US
dc.contributor.authorLeung, TW-
dc.date.accessioned2014-09-19T19:48:26Z-
dc.date.available2014-09-19T19:48:26Z-
dc.date.issued2014en_US
dc.identifier.citationThe European Society for Medical Oncology (ESMO) 16th World Congress on Gastrointestinal Cancer, Barcelona, Spain, 25–28 June 2014. In Annals of Oncology, 2014, v. 25 n. Suppl. 2, p. ii41-ii42, abstract no. P-0093en_US
dc.identifier.issn0923-7534-
dc.identifier.urihttp://hdl.handle.net/10722/203990-
dc.descriptionPoster Presentation-
dc.description.abstractIntroduction: Inoperable hepatocellular carcinoma (HCC) confers a grave prognosis especially those exhibiting portal vein invasion. Radioembolization with yttrium-90 microspheres as selective internal radiation therapy demonstrated favorable outcomes for this intractable disease.We reported our series of patients with extremely advanced unresectable HCC treated with yttrium-90 micospheres. Methods: Patients with extremely advanced inoperable and evaluable HCC including those with single lesion >8cm in maximal diameter or multiple bi-lobar lesions (total >5 lesions) or portal vein invasion were evaluated by hepatic angiography and macroalbumin aggregate (MAA) scan for feasiblity for radioembolization. Dose of yttrium-90 was determined by Body Surface Area (BSA) method with an aim to achieve dose to tumour >200Gy, dose to normal liver <80Gy and lung shunting <10%. Treatment outcomes including best local response rate, best local disease control rate, progression-free survival (PFS), overall survival (OS) and toxicity were assessed. Univariate and multivariate analysis were also performed any prognostic factors for survival. Results: After pre-treatment hepatic angiography and MAA scan, 28 patients with a median age of 63.0 years (range 36-84) were considered feasible for SIRT. All patients have evaluable lesions for response assessment. Prior treatment before radioembolization was performed in 17 patients (60.7%), including 14 patients (50.0%) who had received transarterial chemoembolization (TACE) before. Mean alpha-feto protein (AFP was 19.5 ng/ml (range 1.0 to 10389.0 ng/ml). Median radioactivity of yttrium-90 prescribed was 1.48 GBq (range 0.85 to 2.30 GBq). After a median follow up of 16.2 months, the best local response rate was 21.4% and the best local disease control rate was 39.3%. Median overall PFS and OS were 3.25 months and 11.5 months respectively. Longer median PFS was noted in those who had prior TACE before radioembolization (7.3 vs. 3.1 months, p = 0.035), duration of AFP response >6 months (11.8 vs. 3.1 months, p = 0.020) and whose tumour had absence of portal vein invasion (4.5 vs. 3.1 months, p = 0.057). Longer median OS were also revealed in those without portal vein invasion (17.1 vs. 4.4 months, p = 0.020) and those whose duration of AFP response >6 months (19.8 vs. 8.2 months, p = 0.008). Four patients (14.3%) developed grade 3 or above toxicity including 1 patient who had persistent radiation peptic ulcer requiring gastrectomy. Univariate analysis showed that prior TACE (p = 0.043) and duration of AFP response >6 months were prognostic of PFS, whereas absence of portal vein invasion (p = 0.027) and duration of AFP response >6 months (p = 0.017) were prognostic factors of OS. Multivariate analysis revealed that prior TACE (p = 0.041) and duration of AFP response >6 months (p = 0.001) were prognostic of both PFS while absence of portal vein invasion (p = 0.050) and duration of AFP response >6 months (p = 0.005) were prognostic of OS. Conclusion: Ytrrium-90 radioembolization was able to produce promising treatment outcomes even in extremely advanced HCC. Absence of portal vein invasion and long AFP response were favorable prognostic factors for OS.-
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://annonc.oxfordjournals.org/en_US
dc.relation.ispartofAnnals of Oncologyen_US
dc.rightsThis is an electronic version of an article published in Annals of Oncology, 2014, v. 25 n. Suppl. 2, p. ii41-ii42, abstract no. P-0093-
dc.titleTreatment Outcomes of Patients with Extremely Advanced Inoperable Hepatocellular Carcinoma (HCC) After Yttrium-90 Radioembolizationen_US
dc.typeConference_Paperen_US
dc.identifier.emailLee, VHF: vhflee@hku.hken_US
dc.identifier.emailLuk, MY: myluk@hkucc.hku.hken_US
dc.identifier.emailTong, CC: tccz01@hku.hken_US
dc.identifier.emailNg, CY: ngchoryi@hku.hken_US
dc.identifier.emailLiu, KY: ricoliu@hkucc.hku.hken_US
dc.identifier.emailKwong, DLW: dlwkwong@hku.hken_US
dc.identifier.emailLeung, TW: ltw920@hkucc.hku.hken_US
dc.identifier.authorityLee, VHF=rp00264en_US
dc.identifier.authorityKwong, DLW=rp00414en_US
dc.identifier.doi10.1093/annonc/mdu165.89-
dc.identifier.hkuros238114en_US
dc.identifier.volume25-
dc.identifier.issueSuppl. 2-
dc.identifier.spageii41, abstract no. P-0093-
dc.identifier.epageii42, abstract no. P-0093-
dc.publisher.placeUnited Kingdom-

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