Azienda Ospedaliero-Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy.
J Hepatol. 2013 Oct;59(4):753-61. doi: 10.1016/j.jhep.2013.05.025. Epub 2013 May 23.
BACKGROUND & AIMS: The European Network on Radioembolization with Yttrium-90 resin microspheres study group (ENRY) conducted a retrospective study to evaluate the outcomes among elderly (≥ 70 years) and younger patients (<70 years) with unresectable hepatocellular carcinoma (HCC) who received radioembolization at 8 European centers.
Patients with confirmed diagnosis of unresectable HCC who either progressed following resection or locoregional treatment and/or who were considered poor candidates for chemoembolization were evaluated by a multidisciplinary team for radioembolization with (90)Y-resin microspheres (SIR-Spheres; Sirtex Medical). The survival outcome and all adverse events were compared between the two age groups.
Between 2003 and 2009, 128 elderly and 197 younger patients received radioembolization. Patients in both groups had similar demographic characteristics. Many elderly and younger patients alike had multinodular, BCLC stage C disease, invading both lobes (p = 0.648). Elderly patients had a lower tumor burden, a smaller median target liver volume (p = 0.016) and appeared more likely to receive segmental treatment (p = 0.054). Radioembolization was equally well tolerated in both cohorts and common procedure-related adverse events were predominantly grade 1-2 and of short duration. No significant differences in survival between the groups were found (p = 0.942) with similar median survival in patients with early, intermediate or advanced BCLC stage disease.
Radioembolization appears to be as well-tolerated and effective for the elderly as it is for younger patients with unresectable HCC. Age alone should not be a discriminating factor for the management of HCC patients.
欧洲钇-90 树脂微球内放射栓塞网络（ENRY）研究小组进行了一项回顾性研究，评估了在 8 个欧洲中心接受放射性栓塞治疗的不可切除肝细胞癌（HCC）老年（≥70 岁）和年轻（＜70 岁）患者的结局。
通过多学科团队评估有明确诊断的不可切除 HCC 患者，这些患者要么在手术后或局部区域治疗后进展，要么被认为不适合化疗栓塞。这些患者均接受（90）Y 树脂微球（SIR-Spheres；Sirtex Medical）放射性栓塞治疗。比较了两组患者的生存结局和所有不良事件。
2003 年至 2009 年，128 例老年患者和 197 例年轻患者接受了放射性栓塞治疗。两组患者的人口统计学特征相似。许多老年和年轻患者均患有多结节、BCLC 分期 C 期、累及两个肝叶的疾病（p = 0.648）。老年患者的肿瘤负荷较低，中位目标肝体积较小（p = 0.016），更有可能接受节段性治疗（p = 0.054）。两组患者对放射性栓塞的耐受性均较好，常见的与操作相关的不良事件主要为 1-2 级，持续时间较短。两组患者的生存无显著差异（p = 0.942），早期、中期和晚期 BCLC 分期患者的中位生存时间相似。
放射性栓塞治疗不可切除 HCC 的老年患者与年轻患者一样耐受良好且有效。年龄本身不应成为 HCC 患者管理的区分因素。
