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Multicenter Evaluation of Survival and Toxicities of Hepatocellular Carcinoma following Radioembolization: Analysis of the RESiN Registry.
- Source :
-
Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2021 Jun; Vol. 32 (6), pp. 845-852. Date of Electronic Publication: 2021 Apr 02. - Publication Year :
- 2021
-
Abstract
- Purpose: To determine overall survival (OS), progression-free survival (PFS), and toxicity in patients with hepatocellular carcinoma (HCC) in a multicenter, real-world data registry using transarterial radioembolization (TARE) with resin microspheres.<br />Materials and Methods: A total of 448 patients with HCC were treated at 36 centers between 2015 and 2019. Treatment history, baseline laboratory and imaging, and treatment goal were assessed. OS and PFS were stratified using Barcelona Clinic Liver Cancer (BCLC) and Child-Pugh (CP) classifications. Kaplan-Meier analyses compared OS and PFS with 95% confidence intervals. Transplants were tracked. Toxicities were assessed using Common Terminology Criteria for Adverse Events v5. Cox proportional hazard of baseline demographics assessed factors affecting survival.<br />Results: Prior chemoembolization and systemic therapy were used in 107 (26%) and 68 (16%) patients, respectively. Using the BCLC staging system, 66 patients (19%) were BCLC A and 202, 51, and 26 were BCLC B, C, and D, respectively. Median OS for patients with BCLC A disease was not achieved at 30 months. Median OS for patients with BCLC B, C, and D disease were 19.5, 13.6, and 11.5 months, respectively (P = .0006). Median PFS for patients with BCLC A, B, C, and D were 19.8, 10.0, 6.3, and 5.9 months, respectively (P = .003). Twenty patients underwent transplantation, representing 14 of 43 (33%) and 6 of 28 (21%) patients who underwent bridging and downstaging therapy, respectively. Common Grade 3 toxicities were encephalopathy (11/448, 2.5%), hyperbilirubinemia (10/448, 2.2%), and ascites (9/448, 2.0%). Factors predicting longer survival included CP A (χ <superscript>2</superscript>  = 4.2, P = .04) and BCLC A (χ <superscript>2</superscript> = 5.2, P = .02).<br />Conclusions: In a frequently pretreated patient cohort with disease burden in 81% beyond the Milan criteria, TARE with resin microspheres provided OS comparable to other studies in this multicenter registry.<br /> (Copyright © 2021 SIR. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Carcinoma, Hepatocellular diagnostic imaging
Carcinoma, Hepatocellular mortality
Disease Progression
Female
Humans
Liver Neoplasms diagnostic imaging
Liver Neoplasms mortality
Male
Microspheres
Middle Aged
Progression-Free Survival
Prospective Studies
Radioisotopes adverse effects
Radiopharmaceuticals adverse effects
Registries
Time Factors
Carcinoma, Hepatocellular radiotherapy
Embolization, Therapeutic adverse effects
Embolization, Therapeutic mortality
Liver Neoplasms radiotherapy
Radioisotopes administration & dosage
Radiopharmaceuticals administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1535-7732
- Volume :
- 32
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of vascular and interventional radiology : JVIR
- Publication Type :
- Academic Journal
- Accession number :
- 33812981
- Full Text :
- https://doi.org/10.1016/j.jvir.2021.03.535