Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, 395 W 12th Avenue, 4th Floor, Columbus, OH 43210 (M.S.M., J.B., A.R.).
Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, 395 W 12th Avenue, 4th Floor, Columbus, OH 43210 (M.S.M., J.B., A.R.).
Acad Radiol. 2024 May;31(5):1828-1835. doi: 10.1016/j.acra.2023.07.007. Epub 2023 Aug 1.
To examine the clinical outcomes of yttrium-90 (Y90) transarterial radioembolization (TARE) for primary hepatocellular carcinoma (HCC) through the evaluation of a 5-year institutional experience.
This retrospective study evaluated 88 consecutive patients with primary HCC receiving Y90 TARE treatment at an academic medical center from 2017 to 2021. Disease distribution was bilobar in 60.2% of patients with an average lesion diameter of 5.0 ± 3.4 cm and Barcelona Clinic Liver Cancer stage B or C in 77% of the participants. Clinical outcomes were elucidated by examination of complications, liver function tests, biochemical response, and radiographic response. Objective response ratio (ORR) and progression-free survival (PFS) were also calculated.
The mean administered Y90 radiation dose was 127.8 ± 20.2 Gy. No significant complications or LFT elevations occurred post-therapy. Of the 73.9% of patients with α-fetoprotein-producing tumors, 67.8% experienced a complete or partial biochemical response 1 month post-treatment. The ORR was 83.3% on 6-month imaging and PFS was 9.6 ± 8.5 months. Functional outcomes (Eastern Cooperative Oncology Group) were maintained or improved in 79.6% and 76.1% of patients by 6 months and 1 year post-treatment, respectively. The mean survival was 14.7 ± 12.1 months. At 6 months post-treatment, 77.3% of patients were downstaged to or maintained Milan criteria, which was sustained for 74.4% and 70.0% of patients 1 year and 2 years after treatment, respectively.
Y90-TARE is a safe and effective therapy for primary HCC. Enduring outcomes further act as a realistic bridge to liver transplantation, with a majority of patients maintaining Milan criteria and preserving their functional status long term.
通过评估一家学术医疗中心的 5 年机构经验，研究钇 90（Y90）经动脉放射性栓塞（TARE）治疗原发性肝细胞癌（HCC）的临床结果。
这项回顾性研究评估了 2017 年至 2021 年期间在一家学术医疗中心接受 Y90 TARE 治疗的 88 例原发性 HCC 连续患者。60.2%的患者疾病分布为双侧，平均病灶直径为 5.0±3.4cm，77%的患者巴塞罗那临床肝癌分期为 B 期或 C 期。通过检查并发症、肝功能试验、生化反应和影像学反应来阐明临床结果。还计算了客观缓解率（ORR）和无进展生存期（PFS）。
平均给予的 Y90 辐射剂量为 127.8±20.2Gy。治疗后无明显并发症或肝功能升高。在 AFP 产生肿瘤的 73.9%的患者中，有 67.8%的患者在治疗后 1 个月出现完全或部分生化缓解。6 个月影像学检查的 ORR 为 83.3%，PFS 为 9.6±8.5 个月。治疗后 6 个月和 1 年，分别有 79.6%和 76.1%的患者的功能结局（东部肿瘤协作组）保持或改善。平均生存期为 14.7±12.1 个月。治疗后 6 个月，77.3%的患者降期至或维持米兰标准，分别有 74.4%和 70.0%的患者在治疗后 1 年和 2 年维持该标准。
Y90-TARE 是治疗原发性 HCC 的一种安全有效的治疗方法。持久的结果进一步成为肝移植的现实桥梁，大多数患者长期维持米兰标准并保持其功能状态。
