Segmental Yttrium-90 Radioembolization versus Segmental Chemoembolization for Localized Hepatocellular Carcinoma: Results of a Single-Center, Retrospective, Propensity Score–Matched Study

Siddharth A. Padia, Guy E. Johnson, Kathryn J. Horton, Christopher R. Ingraham, Matthew J. Kogut, Sharon Kwan, Sandeep Vaidya, Wayne L. Monsky, James O. Park, Renuka Bhattacharya, Daniel S. Hippe, William P. Harris

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68 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)777-785.e1
JournalJournal of Vascular and Interventional Radiology
Volume28
Issue number6
DOIs
StatePublished - Jun 2017
Externally publishedYes

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