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Conference Paper: Radioembolization with yttrium-90 microspheres for inoperable advanced hepatocellular carcinoma (HCC)
Title | Radioembolization with yttrium-90 microspheres for inoperable advanced hepatocellular carcinoma (HCC) |
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Authors | |
Issue Date | 2013 |
Publisher | Hong Kong College of Radiologists. |
Citation | The 5th Joint Scientific Meeting of The Royal College of Radiologists (RCR) & Hong Kong College of Radiologists (HKCR) and 21st Annual Scientific Meeting of HKCR, Hong Kong, 2-3 November 2013. How to Cite? |
Abstract | Objective: Inoperable hepatocellular carcinoma (HCC) confers a grave prognosis. Radioembolization with yttrium-90 microspheres as selective internal radiation therapy (SIRT) was shown to a have favorable outcomes for HCC. We reported our series of patients with inoperable advanced HCC treated in a single institution. Materials and methods: Patients with inoperable HCC and evaluable target lesions were evaluated by hepatic angiography and macroalbumin aggregate (MAA) scan for feasibility for SIRT. Dose of yttrium-90 was decided by Body Surface Area (BSA) method with an aim to achieve dose to tumour ³200Gy and dose to normal liver <80Gy. Treatment outcomes including best local response rate, best local disease control rate, best overall objective response, disease control rate, progression-free survival (PFS), overall survival (OS) and toxicity were assessed. Univariate and multivariate analysis were also performed for any prognostic factors for PFS and OS. Results: 48 inoperable advanced HCC patients, majority of whom with tumour size ³8cm or portal vein invasion, were evaluated for SIRT. After pre-treatment hepatic angiography and macroalbumin aggregate (MAA) scan, 26 patients (54.2%) with a mean age of 61.6 years (range 36-84) were considered feasible and treated with SIRT and 24 patients had evaluable lesions for response assessment. Previous treatment for their HCC was performed in 15 patients (62.5%), including 11 patients (45.8%) who had received transarterial chemoembolization (TACE) before. Mean alpha-feto protein (AFP) was 1187.5ng/ml (range 2.0 to 10389.0 ng/ml). Mean radioactivity of yttrium-90 prescribed was 1.43 GBq (range 0.85 to 2.30 GBq). After a median follow up of 13.9 months, the best local response rate was 33.3% and the best local disease control rate was 54.2%. Median local PFS, overall PFS and OS survival was 3.3 months, 3.2 months and 11.6 months respectively. Patients belonging to Pugh-Child Class A enjoyed longer median OS survival (15.0 months) than those belonging to Pugh-Child B (4.3 months, p=0.014). Similarly, patients whose duration of AFP response ³9 months survived longer (median OS 19.9 months) than whose duration of AFP response <9 months (median OS 8.2 months, p=0.001). Four patients (16.7%) developed grade ³3 toxicity including 1 patient who had persistent radiation peptic ulcer requiring gastrectomy. Univariate analysis showed that radioactivity of yttrium-90 prescribed was prognostic of local progression-free survival (p=0.004), whereas portal vein invasion (p=0.018) and radioactivity of yttrium-90 prescribed (p=0.000) were prognostic of overall progression-free survival and radioactivity of yttrium-90 prescribed (p=0.005), portal vein invasion (p=0.021), dose to tumour (p=0.028) was prognostic factors of OS. Multivariate analysis revealed that duration of AFP response (p=0.011) was prognostic of overall progression-free survival and duration of AFP response (p=0.033) and Pugh-Child Class A (p=0.015) were prognostic of OS. Conclusion: SIRT with yttrium-90 microspheres for inoperable HCC patients produced promising treatment response. |
Persistent Identifier | http://hdl.handle.net/10722/194772 |
DC Field | Value | Language |
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dc.contributor.author | Leung, DKC | en_US |
dc.contributor.author | Lee, VHF | en_US |
dc.contributor.author | Liu, KY | en_US |
dc.contributor.author | Luk, MY | en_US |
dc.contributor.author | Law, WM | en_US |
dc.contributor.author | Tso, WK | en_US |
dc.contributor.author | Wong, KK | en_US |
dc.contributor.author | Wong, KK | en_US |
dc.contributor.author | Ma, VWH | en_US |
dc.contributor.author | Ng, CY | en_US |
dc.contributor.author | Poon, RTP | en_US |
dc.contributor.author | Tong, CC | en_US |
dc.contributor.author | Leung, TW | en_US |
dc.date.accessioned | 2014-02-17T02:09:15Z | - |
dc.date.available | 2014-02-17T02:09:15Z | - |
dc.date.issued | 2013 | en_US |
dc.identifier.citation | The 5th Joint Scientific Meeting of The Royal College of Radiologists (RCR) & Hong Kong College of Radiologists (HKCR) and 21st Annual Scientific Meeting of HKCR, Hong Kong, 2-3 November 2013. | en_US |
dc.identifier.uri | http://hdl.handle.net/10722/194772 | - |
dc.description.abstract | Objective: Inoperable hepatocellular carcinoma (HCC) confers a grave prognosis. Radioembolization with yttrium-90 microspheres as selective internal radiation therapy (SIRT) was shown to a have favorable outcomes for HCC. We reported our series of patients with inoperable advanced HCC treated in a single institution. Materials and methods: Patients with inoperable HCC and evaluable target lesions were evaluated by hepatic angiography and macroalbumin aggregate (MAA) scan for feasibility for SIRT. Dose of yttrium-90 was decided by Body Surface Area (BSA) method with an aim to achieve dose to tumour ³200Gy and dose to normal liver <80Gy. Treatment outcomes including best local response rate, best local disease control rate, best overall objective response, disease control rate, progression-free survival (PFS), overall survival (OS) and toxicity were assessed. Univariate and multivariate analysis were also performed for any prognostic factors for PFS and OS. Results: 48 inoperable advanced HCC patients, majority of whom with tumour size ³8cm or portal vein invasion, were evaluated for SIRT. After pre-treatment hepatic angiography and macroalbumin aggregate (MAA) scan, 26 patients (54.2%) with a mean age of 61.6 years (range 36-84) were considered feasible and treated with SIRT and 24 patients had evaluable lesions for response assessment. Previous treatment for their HCC was performed in 15 patients (62.5%), including 11 patients (45.8%) who had received transarterial chemoembolization (TACE) before. Mean alpha-feto protein (AFP) was 1187.5ng/ml (range 2.0 to 10389.0 ng/ml). Mean radioactivity of yttrium-90 prescribed was 1.43 GBq (range 0.85 to 2.30 GBq). After a median follow up of 13.9 months, the best local response rate was 33.3% and the best local disease control rate was 54.2%. Median local PFS, overall PFS and OS survival was 3.3 months, 3.2 months and 11.6 months respectively. Patients belonging to Pugh-Child Class A enjoyed longer median OS survival (15.0 months) than those belonging to Pugh-Child B (4.3 months, p=0.014). Similarly, patients whose duration of AFP response ³9 months survived longer (median OS 19.9 months) than whose duration of AFP response <9 months (median OS 8.2 months, p=0.001). Four patients (16.7%) developed grade ³3 toxicity including 1 patient who had persistent radiation peptic ulcer requiring gastrectomy. Univariate analysis showed that radioactivity of yttrium-90 prescribed was prognostic of local progression-free survival (p=0.004), whereas portal vein invasion (p=0.018) and radioactivity of yttrium-90 prescribed (p=0.000) were prognostic of overall progression-free survival and radioactivity of yttrium-90 prescribed (p=0.005), portal vein invasion (p=0.021), dose to tumour (p=0.028) was prognostic factors of OS. Multivariate analysis revealed that duration of AFP response (p=0.011) was prognostic of overall progression-free survival and duration of AFP response (p=0.033) and Pugh-Child Class A (p=0.015) were prognostic of OS. Conclusion: SIRT with yttrium-90 microspheres for inoperable HCC patients produced promising treatment response. | en_US |
dc.language | eng | en_US |
dc.publisher | Hong Kong College of Radiologists. | en_US |
dc.relation.ispartof | RCR/HKCR 2013 Joint Scientific Meeting & 21st ASM of HKCR | en_US |
dc.title | Radioembolization with yttrium-90 microspheres for inoperable advanced hepatocellular carcinoma (HCC) | en_US |
dc.type | Conference_Paper | en_US |
dc.identifier.email | Lee, VHF: vhflee@hku.hk | en_US |
dc.identifier.email | Liu, KY: ricoliu@hkucc.hku.hk | en_US |
dc.identifier.email | Luk, MY: myluk@hkucc.hku.hk | en_US |
dc.identifier.email | Wong, KK: nmkkwong@hkucc.hku.hk | en_US |
dc.identifier.email | Ng, CY: ngchoryi@hku.hk | en_US |
dc.identifier.email | Poon, RTP: poontp@hku.hk | en_US |
dc.identifier.email | Tong, CC: tccz01@hku.hk | en_US |
dc.identifier.email | Leung, TW: ltw920@hkucc.hku.hk | en_US |
dc.identifier.authority | Lee, VHF=rp00264 | en_US |
dc.identifier.authority | Poon, RTP=rp00446 | en_US |
dc.identifier.hkuros | 227942 | en_US |
dc.publisher.place | Hong Kong | en_US |