Please use this identifier to cite or link to this item: doi:10.22028/D291-41509
Title: Safety and Efficacy of Selective Internal Radionuclide Therapy with 90Y Glass Microspheres in Patients with Progressive Hepatocellular Carcinoma after the Failure of Repeated Transarterial Chemoembolization
Author(s): Bellendorf, Alexander
Mader, Nicolai
Mueller, Stefan P.
Ezziddin, Samer
Bockisch, Andreas
Grafe, Hong
Best, Jan
Goebel, Juliane
Pöppel, Thorsten D.
Sabet, Amir
Language: English
Title: Pharmaceuticals
Volume: 17
Issue: 1
Publisher/Platform: MDPI
Year of Publication: 2024
Free key words: selective internal radionuclide therapy (SIRT)
90Y glass microspheres
hepatocellular carcinoma (HCC)
transarterial chemoembolization (TACE)
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Transarterial chemoembolization (TACE) is currently the standard of care in patients with unresectable hepatocellular carcinoma (HCC), and selective internal radionuclide therapy (SIRT) with 90Y microspheres is mainly used as an alternative modality in patients considered poor candidates for TACE. Treatment with sorafenib is the recommended option for patients with progressive disease after TACE. This study aims to evaluate the safety and efficacy of SIRT with glass microspheres in patients with progressive HCC after repeated TACE who are not eligible for treatment with sorafenib. Forty-seven patients with progressive HCC after a median of three TACE sessions (range 2–14) underwent SIRT (3.5 ± 1.5 GBq; liver target dose 110–120 Gy). Toxicity was recorded 4 and 12 weeks after treatment and reported according to the Common Terminology Criteria for Adverse Events Version 5.0. Treatment response was assessed three months after SIRT using multiphase computed tomography and modified criteria in solid tumors (mRECIST). Survival analyses were performed using Kaplan–Meier curves and a Cox proportional hazards model for uni- and multivariate analyses. Significant but reversible hepatotoxicity (≥grade 3) occurred in five patients (11%). No radioembolization-induced liver disease (REILD) was observed. The number of previous TACE sessions and cumulative administered activity did not predict the incidence of postSIRT significant hepatotoxicity. Treatment responses consisted of partial responses in 26 (55%), stable disease in 12 (26%), and progressive disease in 9 (19%) patients. The median overall survival (OS) was 11 months (95% confidence interval (CI), 9–13), and objective responses to SIRT were associated with a longer OS (p = 0.008). Significant hepatotoxicity (≥grade 3) after SIRT was a contributor to impaired survival (median OS 6 months (95% CI, 4–8) vs. 12 months (95% CI, 10–14), p < 0.001). SIRT with glass microspheres is a safe and effective salvage treatment for patients with progressive HCC refractory to TACE who are considered poor candidates for sorafenib treatment.
DOI of the first publication: 10.3390/ph17010101
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-415099
ISSN: 1424-8247
Date of registration: 29-Jan-2024
Faculty: M - Medizinische Fakultät
Department: M - Radiologie
Professorship: M - Prof. Dr. Samer Ezziddin
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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