scholarly journals Yttrium-90 Microspheres for Intermediate- or Advanced-Stage Hepatocellular Carcinoma

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Calvin Young ◽  
Anusree Subramonian ◽  
Charlene Argáez
Keyword(s):  
Hepatocellular Carcinoma ◽  
Adverse Events ◽  
Transarterial Chemoembolization ◽  
Systemic Treatment ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Advanced Stage ◽  
Transarterial Radioembolization ◽  
90Y Microspheres ◽  
Yttrium 90

Transarterial radioembolization using yttrium-90 (90Y) microspheres is a therapeutic option for patients with intermediate- or advanced-stage hepatocellular carcinoma, including those with recurrent or inoperable hepatocellular carcinoma. Overall, the evidence suggests that patients treated with 90Y-based transarterial radioembolization may experience no difference in overall survival, progression-free survival, and tumour response when compared to patients who received transarterial chemoembolization therapies or systemic treatment with sorafenib or lenvatinib. Patients treated with transarterial radioembolization generally experienced similar rates of adverse events compared to those treated with transarterial chemoembolization, although there were some instances where treatment with transarterial radioembolization led to increased or decreased risks of specific adverse events. The comparative safety of transarterial radioembolization versus systemic treatment with sorafenib was unclear as the included studies did not statistically compare the risks of experiencing adverse events. Evidence regarding the cost-effectiveness of 90Y microspheres for treating hepatocellular carcinoma is conflicting. Three economic evaluations suggest treatment with transarterial radioembolization is likely to be cost-effective or dominant — less costly and more effective — compared to transarterial chemoembolization or systemic therapies, while a single economic study suggested treatment with sorafenib or lenvatinib is most likely to be cost-effective or dominant compared to transarterial radioembolization.

Phase II trial of sorafenib combined with on-demand transarterial chemoembolization for advanced stage hepatocellular carcinoma (Barcelona Clinic Liver Cancer stage C): STAB study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15648-e15648
Author(s):  
Yozo Sato ◽  
Hideyuki Nishiofuku ◽  
Taku Yasumoto ◽  
Atsuhiro Nakatsuka ◽  
Kunihiro Matsuo ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cancer ◽  
Combination Therapy ◽  
Adverse Events ◽  
Transarterial Chemoembolization ◽  
Group Performance ◽  
Barcelona Clinic Liver Cancer ◽  
Cancer Stage ◽  
Advanced Stage ◽  
On Demand

e15648 Background: Sorafenib has been acknowledged as a standard treatment for advanced stage hepatocellular carcinoma (HCC). This study was conducted to evaluate the safety and efficacy of combination therapy of sorafenib and on-demand transarterial chemoembolization (TACE) for advanced stage HCC. Methods: Inclusion criteria were advanced stage HCC (Barcelona Clinic Liver Cancer stage C), a systemic chemotherapy native status, an Eastern Cooperative Oncology Group performance status 0–1, and a Child-Pugh grade-A. Sorafenib therapy (800 mg daily) was started 4–28 days after TACE. On-demand TACE was allowed. The primary endpoint was the completion rate of protocol treatment, which was defined as sorafenib administration at least for 2 months from initial TACE. Secondary endpoints were objective response rate (ORR), disease control rate (DCR) based on modified Response Evaluation Criteria in Solid Tumors, overall survival (OS), progression-free survival (PFS), and the incidence of adverse events. Results: From July 2013 to September 2015, a total of 32 patients were registered from 9 institutions, but one patient was excluded because his tumor turned out to be combined hepatocellular carcinoma and cholangiocarcinoma. The protocol treatment was completed in 28 of 31 enrolled patients (90.3%, 28/31). The median treatment duration was 7.0 months (range 0.5–30) with the median number of TACE was 1 (range 1–4) and the median sorafenib dosage of 400 mg daily (range 154-800). The ORR and DCR were 77% and 90%, respectively. Median OS and PFS were 17.3 months [95% confidence interval (CI), 11.9–22.6] and 5.4 months (95% CI, 4.6–6.2), respectively. The most common grade-3 or -4 adverse events were increased aspartate aminotransferase (55%, 17/31), increased alanine aminotransferase (45% 14/31), and hypertension (23%, 7/31). Conclusions: Combination therapy of sorafenib and on-demand TACE was well tolerated and safe. Furthermore, this combination treatment may provide a survival benefit to patients with advanced stage HCC. Clinical trial information: UMIN000014213.

scholarly journals Transarterial Radioembolization with Yttrium-90 for the Treatment of Hepatocellular Carcinoma

2016 ◽  
Vol 33 (5) ◽  
pp. 699-714 ◽  
Author(s):  
Joseph Ralph Kallini ◽  
Ahmed Gabr ◽  
Riad Salem ◽  
Robert J. Lewandowski
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Radioembolization ◽  
Yttrium 90

Stereotactic Body Radiation Therapy as a Salvage Treatment for Single Viable Hepatocellular Carcinoma at the Site of Incomplete Transarterial Chemoembolization

2021 ◽  
Author(s):  
Sumin Lee ◽  
Jinhong Jung ◽  
Jin-hong Park ◽  
So Yeon Kim ◽  
Jonggi Choi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiation Therapy ◽  
Adverse Events ◽  
Transarterial Chemoembolization ◽  
Stereotactic Body Radiation Therapy ◽  
Medical Center ◽  
Salvage Treatment ◽  
Iodized Oil ◽  
Stereotactic Body Radiation

Abstract Background: To evaluate the clinical outcomes of patients who received stereotactic body radiation therapy (SBRT) for single viable hepatocellular carcinoma (HCC) at the site of incomplete transarterial chemoembolization (TACE).Methods: Incomplete TACE was defined as (1) evidence of viable HCC at the site of TACE on follow-up images following one or more consecutive TACEs, (2) no definite tumor staining on celiac angiogram, or (3) no definite iodized oil uptake on post-embolization angiogram or computed tomography. A total of 302 patients were treated between 2012 and 2017 at Asan Medical Center (Seoul, South Korea). Doses of 10–15 Gy per fraction were given over 3–4 consecutive days. Treatment-related adverse events were evaluated according to the common terminology criteria for adverse events, version 4.03.Results: The median follow-up duration was 32.9 months (interquartile range [IQR], 23.6–41.7) and the median tumor size was 2.0 cm (range, 0.7–6.9). The local control (LC) and overall survival rates at 3 years were 91.2% and 72.7%, respectively. 95.4% of the tumors reached complete response (CR) during the entire follow-up period (anyCR). The median interval from SBRT to anyCR was 3.4 months (IQR, 1.9–4.7), and 39.9% and 83.3% of the lesions reached CR at 3- and 6-months after SBRT, respectively. Radiation-induced liver disease was observed in 8 (2.6%) patients. No patients experienced gastroduodenal bleeding within the radiation field.Conclusion: SBRT should be considered a feasible salvage treatment option for HCC after incomplete TACE.

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