Son Sam Y, Geevarghese Ruben, Marinelli Brett, Zhao Ken, Covey Anne, Maxwell Aaron, Wei Alice C, Jarnagin William, D'Angelica Michael, Yarmohammadi Hooman
Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065, USA.
Department of Radiology, Division of Interventional Radiology, Warren Alpert Medical School of Brown University, One Prospect Steet, Providence, RI 02912, USA.
Cancers (Basel). 2024 Aug 30;16(17):3024. doi: 10.3390/cancers16173024.
BACKGROUND/OBJECTIVES: The aim of this study was to assess the efficacy of boosted dose yttrium-90 radioembolization (TARE) as a modality for conversion therapy to transplant or surgical resection in patients with unresectable hepatocellular carcinoma (HCC).
In this single-center retrospective study, all patients with a diagnosis of HCC who were treated with boosted dose TARE (>190 Gy) between January 2013 and December 2023 were reviewed. Treatment response and decrease in tumor size were assessed with the RECIST v1.1 and mRECIST criteria. Milan and University of California, San Francisco (UCSF), criteria were used to determine transplant eligibility, and Barcelona Clinic Liver Cancer (BCLC) surgical resection recommendations were used to evaluate tumor resectability.
Thirty-eight patients with primary HCC who were treated with boosted dose TARE were retrospectively analyzed. The majority of the patients were Child-Pugh A ( = 35; 92.1%), BCLC C ( = 17; 44.7%), and ECOG performance status 0 ( = 25; 65.8%). The mean sum of the target lesions was 6.0 cm (standard deviation; SD = 4.0). The objective response rate (ORR) was 31.6% by RECIST and 84.2% by mRECIST. The disease control rate (DCR) was 94.7% by both RECIST and mRECIST. Among patients outside of Milan or UCSF, 13/25 (52.0%, Milan) and 9/19 (47.4%, UCSF) patients were successfully converted to within transplant criteria. Of patients who were initially unresectable, conversion was successful in 7/26 (26.9%) patients.
This study provides further real-world data demonstrating that boosted-dose TARE is an effective modality for conversion of patients with unresectable HCC to transplant or resection.
背景/目的：本研究旨在评估高剂量钇-90放射性栓塞（TARE）作为不可切除肝细胞癌（HCC）患者转化为移植或手术切除治疗方式的疗效。
在这项单中心回顾性研究中，对2013年1月至2023年12月期间接受高剂量TARE（>190 Gy）治疗的所有HCC诊断患者进行了回顾。采用RECIST v1.1和mRECIST标准评估治疗反应和肿瘤大小的减小情况。使用米兰标准和加利福尼亚大学旧金山分校（UCSF）标准来确定移植资格，并使用巴塞罗那临床肝癌（BCLC）手术切除建议来评估肿瘤可切除性。
对38例接受高剂量TARE治疗的原发性HCC患者进行了回顾性分析。大多数患者为Child-Pugh A级（n = 35；92.1%），BCLC C期（n = 17；44.7%），东部肿瘤协作组（ECOG）体能状态为0（n = 25；65.8%）。目标病灶的平均总和为6.0 cm（标准差；SD = 4.0）。根据RECIST标准，客观缓解率（ORR）为31.6%，根据mRECIST标准为84.2%。根据RECIST和mRECIST标准，疾病控制率（DCR）均为94.7%。在米兰或UCSF标准之外的患者中，13/25（52.0%，米兰标准）和9/19（47.4%，UCSF标准）患者成功转化为符合移植标准。在最初不可切除的患者中，7/26（26.9%）患者转化成功。
本研究提供了进一步的真实世界数据，表明高剂量TARE是将不可切除HCC患者转化为移植或切除的有效方式。
