Sólymos Petra, Rédei Mátyás, Turan Caner, Szabó Bence, Ádám Alexandra, Molnár Zsolt, Duray Gábor, Hegyi Péter, Horváthy Dénes B
Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary.
Department of Radiology, Medical Imaging Centre, Semmelweis University, 1082 Budapest, Hungary.
Cancers (Basel). 2025 May 31;17(11):1841. doi: 10.3390/cancers17111841.
BACKGROUND/OBJECTIVES: This systematic review and meta-analysis evaluated the effectiveness and the safety of transarterial radioembolization using Holmium-166 microspheres (Ho-166-TARE) for the treatment of primary and secondary liver tumors. The aim of the study was to offer a detailed analysis of clinical outcomes and the potential benefits of this innovative therapy.
The study was conducted according to the PRISMA 2020 guidelines. The systematic search was performed in five databases in November 2023 and updated in June 2024. All 16 eligible studies were original research that evaluated Ho-166-TARE. The endpoints analyzed were disease control rate (DCR), overall survival (OS), progression-free survival (PFS), clinical and laboratory adverse events, healthy-liver- and tumor-liver-absorbed doses. The risk of bias was assessed using the MINORS checklist.
The pooled overall disease control rate (DCR) was 72% (95% CI, 46-89%); by mRECIST, it was 93% (95% CI, 71-99%); and by RECIST 1.1, it was 54% (95% CI, 22-83%) at 3-month follow-up. Overall survival (OS) at 3, 6, 12, and 30 months was 98%, 89%, 74%, and 39%, respectively. Severe clinical adverse events were minimal, although some patients showed elevated GGT levels and lymphocytopenia. Tumor-absorbed doses were nearly three times higher than those in healthy liver tissue.
These findings suggest that Ho-166-TARE is a safe and effective locoregional treatment option for liver tumors, especially in cases where systemic therapy alone is insufficient or surgical resection is not feasible. Further studies are needed to investigate tumor-specific response, optimize dosimetry strategies, and establish standardized protocols for long-term outcome assessment.
背景/目的：本系统评价和荟萃分析评估了使用钬-166微球（Ho-166-TARE）进行经动脉放射性栓塞治疗原发性和继发性肝肿瘤的有效性和安全性。本研究的目的是对这一创新疗法的临床结果和潜在益处进行详细分析。
本研究按照PRISMA 2020指南进行。2023年11月在五个数据库中进行了系统检索，并于2024年6月更新。所有16项符合条件的研究均为评估Ho-166-TARE的原始研究。分析的终点包括疾病控制率（DCR）、总生存期（OS）、无进展生存期（PFS）、临床和实验室不良事件、健康肝脏和肿瘤肝脏吸收剂量。使用MINORS清单评估偏倚风险。
在3个月随访时，汇总的总体疾病控制率（DCR）为72%（95%CI，46-89%）；根据mRECIST标准为93%（95%CI，71-99%）；根据RECIST 1.1标准为54%（95%CI，22-83%）。3、6、12和30个月时的总生存期（OS）分别为98%、89%、74%和39%。严重临床不良事件极少，尽管一些患者谷氨酰转肽酶（GGT）水平升高和淋巴细胞减少。肿瘤吸收剂量几乎是健康肝脏组织的三倍。
这些发现表明，Ho-166-TARE是一种安全有效的肝肿瘤局部治疗选择，特别是在单独全身治疗不足或手术切除不可行的情况下。需要进一步研究以调查肿瘤特异性反应、优化剂量测定策略并建立长期结果评估的标准化方案。
