Document Detail


Yttrium-90 radioembolization for the treatment of unresectable hepatocellular carcinoma in patients with transjugular intrahepatic portosystemic shunts.
MedLine Citation:
PMID:  23273699     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: To evaluate the toxicity and response to radioembolization with yttrium-90 ((90)Y) glass microspheres in patients with hepatocellular carcinoma (HCC) and existing transjugular intrahepatic portosystemic shunts (TIPS).
MATERIALS AND METHODS: For treatment of unresectable HCC, 12 patients with a patent TIPS underwent a total of 21 infusions of (90)Y. Toxicity within 90 days of treatment was assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE v4.0). Imaging response within the index lesion was assessed using the World Health Organization (WHO) and European Association for the Study of the Liver (EASL) guidelines. Survival was calculated using the Kaplan-Meier method.
RESULTS: All patients had a patent TIPS on imaging before treatment. Clinical toxicities included fatigue (83%), encephalopathy (33%), and abdominal pain (25%). Three patients (25%) experienced new grade 3 or 4 bilirubin toxicity. Imaging response was achieved in 50% and 67% of patients according to WHO and EASL criteria. Six patients (50%) went on to liver transplantation. Median survival censored for liver transplantation was 498 days (95% confidence interval [CI],100-800 d), and uncensored median survival was 827 days (95% CI, 250-2,400 d).
CONCLUSIONS: (90)Y radioembolization may be a safe and effective treatment for patients with unresectable HCC and existing TIPS. This minimally embolic therapy may be particularly useful as a bridge to curative liver transplantation.
Authors:
Laurence A Donahue; Laura Kulik; Talia Baker; Daniel R Ganger; Ramona Gupta; Khairuddin Memon; Michael M Abecassis; Riad Salem; Robert J Lewandowski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  24     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  74-80     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiology, Section of Interventional Radiology.
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