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. 2020 Sep;8(17):1055.
doi: 10.21037/atm-20-2658.

Repeated radioembolization in advanced liver cancer

Max Masthoff  1 , Philipp Schindler  1 , Fabian Harders  1 , Walter Heindel  1 , Christian Wilms  2 , Hartmut H Schmidt  2 , Andreas Pascher  3 , Lars Stegger  4 , Kambiz Rahbar  4 , Moritz Wildgruber  1   5 , Michael Köhler  1
Affiliations

Repeated radioembolization in advanced liver cancer

Max Masthoff et al. Ann Transl Med. 2020 Sep.

Abstract

Background: To evaluate safety and clinical outcome of repeated transarterial 90Y (yttrium) radioembolization (TARE) in primary and metastatic liver cancer.

Methods: Between 2009 and 2018, n=288 patients underwent TARE for treatment of malignant liver disease in a tertiary care hospital. This retrospective single center study analyzed the safety and outcome of patients (n=11/288) undergoing repeated resin microsphere TARE. Included patients suffered from hepatocellular carcinoma (n=3), colorectal cancer (n=2), breast cancer (n=2), intrahepatic cholangiocarcinoma (n=3), and neuroendocrine carcinoma (n=1). All patients had shown either partial response (n=9) or stable disease (n=2) after first TARE. Lab parameters, response assessed by the Response Evaluation Criteria in Solid Tumors (mRECIST/RECIST) at 3 months and overall survival was analyzed. Additionally, patients with repeated TARE were compared to a matched control group (n=56) with single TARE therapy. Kaplan Meier analysis was performed to analyze survival.

Results: Patients after repeated TARE showed similar increase in lab parameters as compared to their first TARE. No case of radioembolization induced liver disease was observed. While n=5/11 patients showed a partial response and n=4/11 patients a stable disease after repeated TARE, only n=2/11 patients suffered from progressive disease. Median overall survival was 20.9±11.9 months for the repeated TARE group while it was 5.9±16.2 months for the control group.

Conclusions: Repeated 90Y TARE is safe and can be of benefit for patients yielding a comparable degree of local disease control compared to patients with singular TARE.

Keywords: 90Y yttrium; Repeated radioembolization; liver cancer.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-20-2658). KR, MW, MK report receiving lectureship compensations and/or proctoring fees by SIRTeX Medical Europe, outside the submitted work. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Kaplan-Meier analysis of survival after repeated 90Y TARE. (A) A significantly higher cumulative survival of patients with repeated TARE (n=11) was observed as compared to matched control group without repeated TARE (n=57; P=0.005). (B) A significantly higher cumulative survival of patients with repeated TARE (n=11) was observed as compared to control subgroups with chemotherapy or no further therapy after first TARE (n=11 or n=33 respectively, P=0.011). 90Y, yttrium-90; TARE, transarterial radioembolization.
See this image and copyright information in PMC

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