Masthoff Max, Schindler Philipp, Harders Fabian, Heindel Walter, Wilms Christian, Schmidt Hartmut H, Pascher Andreas, Stegger Lars, Rahbar Kambiz, Wildgruber Moritz, Köhler Michael
Institute of Clinical Radiology, University Hospital Muenster, Muenster, Germany.
Department of Gastroenterology and Hepatology, University Hospital Muenster, Muenster, Germany.
Ann Transl Med. 2020 Sep;8(17):1055. doi: 10.21037/atm-20-2658.
To evaluate safety and clinical outcome of repeated transarterial Y (yttrium) radioembolization (TARE) in primary and metastatic liver cancer.
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.
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.
Repeated Y TARE is safe and can be of benefit for patients yielding a comparable degree of local disease control compared to patients with singular TARE.
评估原发性和转移性肝癌重复经动脉钇（Y）放射性栓塞术（TARE）的安全性和临床结局。
2009年至2018年期间，n = 288例患者在一家三级护理医院接受TARE治疗恶性肝病。这项回顾性单中心研究分析了接受重复树脂微球TARE的患者（n = 11/288）的安全性和结局。纳入的患者患有肝细胞癌（n = 3）、结直肠癌（n = 2）、乳腺癌（n = 2）、肝内胆管癌（n = 3）和神经内分泌癌（n = 1）。所有患者在首次TARE后均显示部分缓解（n = 9）或疾病稳定（n = 2）。分析实验室参数、3个月时根据实体瘤疗效评价标准（mRECIST/RECIST）评估的反应以及总生存期。此外，将接受重复TARE的患者与接受单次TARE治疗的匹配对照组（n = 56）进行比较。采用Kaplan-Meier分析来分析生存期。
与首次TARE相比，重复TARE后的患者实验室参数有类似升高。未观察到放射性栓塞诱导的肝病病例。重复TARE后，n = 5/11的患者显示部分缓解，n = 4/11的患者疾病稳定，只有n = 2/11的患者病情进展。重复TARE组的中位总生存期为20.9±11.9个月，而对照组为5.9±16.2个月。
重复钇TARE是安全的，与单次TARE的患者相比，对于实现可比程度局部疾病控制的患者可能有益。
