TY - JOUR
T1 - Segmental Yttrium-90 Radioembolization versus Segmental Chemoembolization for Localized Hepatocellular Carcinoma
T2 - Results of a Single-Center, Retrospective, Propensity Score–Matched Study
AU - Padia, Siddharth A.
AU - Johnson, Guy E.
AU - Horton, Kathryn J.
AU - Ingraham, Christopher R.
AU - Kogut, Matthew J.
AU - Kwan, Sharon
AU - Vaidya, Sandeep
AU - Monsky, Wayne L.
AU - Park, James O.
AU - Bhattacharya, Renuka
AU - Hippe, Daniel S.
AU - Harris, William P.
N1 - Publisher Copyright:
© 2017 SIR
PY - 2017/6
Y1 - 2017/6
N2 - Purpose To compare segmental radioembolization with segmental chemoembolization for localized, unresectable hepatocellular carcinoma (HCC) not amenable to ablation. Materials and Methods In a single-center, retrospective study (2010–2015), 101 patients with 132 tumors underwent segmental radioembolization, and 77 patients with 103 tumors underwent segmental doxorubicin-based drug-eluting embolic or conventional chemoembolization. Patients receiving chemoembolization had worse performance status (Eastern Cooperative Oncology Group 0, 76% vs 56%; P =.003) and Child-Pugh class (class A, 65% vs 52%; P =.053); patients receiving radioembolization had larger tumors (32 mm vs 26 mm; P <.001), more infiltrative tumors (23% vs 9%; P =.01), and more vascular invasion (18% vs 1%; P <.001). Toxicity, tumor response, tumor progression, and survival were compared. Analyses were weighted using a propensity score (PS). Results Toxicity rates were low, without significant differences. Index and overall complete response rates were 92% and 84% for radioembolization and 74% and 58% for chemoembolization (P =.001 and P <.001). Index tumor progression at 1 and 2 years was 8% and 15% in the radioembolization group and 30% and 42% in the chemoembolization group (P <.001). Median progression-free and overall survival were 564 days and 1,198 days in the radioembolization group and 271 days and 1,043 days in the chemoembolization group (PS-adjusted P =.002 and P =.35; censored by transplant PS-adjusted P <.001 and P =.064). Conclusions Segmental radioembolization demonstrates higher complete response rates and local tumor control compared with segmental chemoembolization for HCC, with similar toxicity profiles. Superior progression-free survival was achieved.
AB - Purpose To compare segmental radioembolization with segmental chemoembolization for localized, unresectable hepatocellular carcinoma (HCC) not amenable to ablation. Materials and Methods In a single-center, retrospective study (2010–2015), 101 patients with 132 tumors underwent segmental radioembolization, and 77 patients with 103 tumors underwent segmental doxorubicin-based drug-eluting embolic or conventional chemoembolization. Patients receiving chemoembolization had worse performance status (Eastern Cooperative Oncology Group 0, 76% vs 56%; P =.003) and Child-Pugh class (class A, 65% vs 52%; P =.053); patients receiving radioembolization had larger tumors (32 mm vs 26 mm; P <.001), more infiltrative tumors (23% vs 9%; P =.01), and more vascular invasion (18% vs 1%; P <.001). Toxicity, tumor response, tumor progression, and survival were compared. Analyses were weighted using a propensity score (PS). Results Toxicity rates were low, without significant differences. Index and overall complete response rates were 92% and 84% for radioembolization and 74% and 58% for chemoembolization (P =.001 and P <.001). Index tumor progression at 1 and 2 years was 8% and 15% in the radioembolization group and 30% and 42% in the chemoembolization group (P <.001). Median progression-free and overall survival were 564 days and 1,198 days in the radioembolization group and 271 days and 1,043 days in the chemoembolization group (PS-adjusted P =.002 and P =.35; censored by transplant PS-adjusted P <.001 and P =.064). Conclusions Segmental radioembolization demonstrates higher complete response rates and local tumor control compared with segmental chemoembolization for HCC, with similar toxicity profiles. Superior progression-free survival was achieved.
UR - http://www.scopus.com/inward/record.url?scp=85016603291&partnerID=8YFLogxK
U2 - 10.1016/j.jvir.2017.02.018
DO - 10.1016/j.jvir.2017.02.018
M3 - Article
C2 - 28365172
AN - SCOPUS:85016603291
SN - 1051-0443
VL - 28
SP - 777-785.e1
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 6
ER -