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. 2021 May 12;21(1):216.
doi: 10.1186/s12876-021-01805-6.

Efficacy and safety of selective internal radiation therapy with yttrium-90 for the treatment of unresectable hepatocellular carcinoma

Nguyen Van Thai  1 , Nguyen Tien Thinh  2 , Thai Doan Ky  1 , Mai Hong Bang  1 , Dinh Truong Giang  1 , Le Ngoc Ha  3 , Mai Hong Son  3 , Dao Duc Tien  4 , Hyun Woong Lee  5
Affiliations

Efficacy and safety of selective internal radiation therapy with yttrium-90 for the treatment of unresectable hepatocellular carcinoma

Nguyen Van Thai et al. BMC Gastroenterol. .

Abstract

Background: This retrospective analysis was undertaken to evaluate the efficiency of SIRT with Y-90 microspheres and determined prognostic factors affecting patients with unresectable HCC.

Methods: A total of 97 patients diagnosed with unresectable HCC who underwent SIRT with Y-90 microspheres. Patient survival was assessed using the Kaplan-Meier method, and prognostic factors affecting survival were assessed using log-rank tests and Cox proportional hazards regression.

Results: Among the 97 patients (90 males, mean age 60.4 ± 12.3 years) who underwent SIRT, the median clinical follow-up was 16.4 (1.8-62) months. The median overall survival (OS) was 23.9 ± 2.4 months. Tumor response according to the Modified RECIST in patients followed up beyond 6 months included a complete response (CR) to treatment in 12 patients (18.8%), partial response (PR) in 23 (35.8%), stable disease (SD) in 8 (12.5%), and progressive disease (PD) in 21 (32.8%). Factors associated with longer OS included age > 65 years, BCLC stage B, tumor size < 5 cm, tumor burden < 25%, and tumor response (CR/PR). In multivariate analysis, unilobar disease and objective tumor response (CR/PR) were predictors of longer OS.

Conclusion: SIRT was an effective treatment for unresectable HCC. Unilobar disease before SIRT and tumor response (CR/PR) were positive prognostic factors.

Keywords: Hepatocellular carcinoma; Selective internal radiation therapy; Survival; Tumor response; Yttrium-90.

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Conflict of interest statement

The authors declare no conflict of interest about this work.

Figures

Fig. 1
Fig. 1
Kaplan–Meier survival curves. (A) Median overall survival was 23.9 months. The median survival after SIRT was 23.9 months with 6-, 12-, 24-, 36-, and 48-month survival of 77.9%, 56.7%, 39.2%, 31%, and 18.5%, respectively
Fig. 2
Fig. 2
Kaplan–Meier curves demonstrating survival based on age, BCLC stage, tumor burden, and tumor response. a The median overall survival is significantly better in patients aged above 65 years than in those aged below 65 years (30.5 vs. 19.1 months; p = 0.017). b The median overall survival was significantly better in patients with BCLC stage B than in those with BCLC stage C (31.2 vs. 21.2 months; p = 0.018). c The median overall survival was significantly better in patients with tumor burden under 25% than in those with tumor burden 25–50% and above 50% (33.1, vs. 15.9 and 9.7 months; p < 0.001). d The median overall survival was significantly better in patients with objective tumor response (CR/PR) than in those with SD/PD (40.1 vs. 16.3 months; p < 0.001)
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