Outcomes of Radioembolization in the Treatment of Hepatocellular Carcinoma with Portal Vein Invasion: Resin versus Glass Microspheres

Biederman, D.; Titano, J.; Tabori, N.; Pierobon, Elisa Sefora; Alshebeeb, Kutaiba; Schwartz, Myron; Facciuto, Marcelo; Gunasekaran, Ganesh; Florman, Sander; Fischman, A.; Patel, Rahul; Nowakowski, F.; Kim, Edward

doi:10.1016/j.jvir.2016.01.147

Cited by 48 publications

(28 citation statements)

References 26 publications

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“…Child‐Pugh and UNOS stage were not included in the multivariate model to limit collinearity artifact. The data are consistent with our initial report of 291 patients as well as other series, with no new safety observations and no attempt to attribute toxicity related to treatment or natural history of cirrhosis …”

Section: Discussionsupporting

confidence: 90%

Institutional decision to adopt Y90 as primary treatment for hepatocellular carcinoma informed by a 1,000‐patient 15‐year experience

et al. 2018

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Section: Discussionsupporting

confidence: 90%

Institutional decision to adopt Y90 as primary treatment for hepatocellular carcinoma informed by a 1,000‐patient 15‐year experience

et al. 2018

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“…First, the current study was a retrospective and single-center study with a relatively limited number of patients. However, our study remains the second largest report after the study of Biederman et al study (13) comparing groups of patients treated by both types of 90 Y microspheres. Second, a further important potential bias was the tumor size.…”

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 90%

“…This report published a significantly higher OS in the 90 Y glass group (P , 0.001) whereas PFS was not higher (P 5 0.48) (13). However, the inaccurate body surface area method was used in the study by Biederman et al (13) and may partly explain the improved OS observed in patients treated with 90 Y glass microspheres. Here, we present the first study, to our knowledge, comparing resin microspheres and glass microspheres using pretreatment PMD and demonstrate that both approaches seem to be comparable in regard to PFS and OS.…”

Section: Discussionmentioning

confidence: 90%

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Resin Versus Glass Microspheres for ⁹⁰Y Transarterial Radioembolization: Comparing Survival in Unresectable Hepatocellular Carcinoma Using Pretreatment Partition Model Dosimetry

et al. 2017

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The aim of this study was to compare survival of patients treated for unresectable hepatocellular carcinoma (uHCC) with 90 Y transarterial radioembolization (TARE) using pretreatment partition model dosimetry (PMD). Methods: We performed a retrospective analysis of prospectively collected data on 77 patients consecutively treated (mean age 6 SD, 66.4 6 12.2 y) for uHCC (36 uninodular, 5 multinodular, 36 diffuse) with 90 Y TARE (41 resin, 36 glass) using pretreatment PMD. Study endpoints were progression-free survival (PFS) and overall survival (OS) assessed by Kaplan-Meier estimates. Several variables including Barcelona Clinic Liver Cancer (BCLC) staging system, tumor size, and serum a-fetoprotein (AFP) level were investigated using Cox proportional hazards regression. Results: The characteristics of 2 groups were comparable with regard to demographic data, comorbidities, Child-Pugh score, BCLC, serum AFP level, and 90 Y global administered activity. The median follow-up time was 7.7 mo (range, 0.4-50.1 mo). Relapse occurred in 44 patients (57%) at a median of 6 mo (range, 0.4-27.9 mo) after 90 Y TARE, and 41 patients (53%) died from tumor progression. Comparison between resin and glass microspheres revealed higher but not statistically significantly PFS and OS rates in the 90 Y resin group than the 90 Y glass group (resin PFS 6.1 mo [95% confidence interval CI, 4.7-7.4] and glass PFS 5 mo [95% CI, 0.9-9.2], P 5 0.53; resin OS 7.7 mo [95% CI, 7.2-8.2] and glass OS 7 mo [95% CI 1.6-12.4], P 5 0.77). No significant survival difference between both types of 90 Y microspheres was observed in any subgroups of patients with early/intermediate or advanced BCLC stages. Among the variables investigated, Cox analyses showed that only in the glass group, the BCLC staging system and the serum AFP level were associated with PFS (P 5 0.04) and OS (P 5 0.04). Tumor size was a prognostic factor without significant influence on PFS and OS after 90 Y TARE. Conclusion: Comparison between resin and glass microspheres revealed no significant survival difference in patients treated for uHCC with 90 Y TARE using pretreatment PMD. Further, larger prospective studies are warranted to confirm these findings.

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“…There are no randomized studies comparing the two microspheres, but current literature has shown similar clinical outcomes [5-9]. One recent article showed lower toxicity and improved overall survival with glass microspheres in the treatment of HCC with portal vein invasion [10]. …”

Section: Microspheresmentioning

confidence: 99%

Radioembolization for the treatment of hepatocellular carcinoma

Kim

2017

Clin Mol Hepatol

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Transarterial radioembolization (TARE) with yttrium 90 (90Y), an intra-arterial procedure performed by interventional radiologists, has begun being utilized in managing hepatocellular carcinoma (HCC) in Korea. There are two available TARE products: glass and resin microspheres with different physical characteristics. All patients undergoing TARE must be assessed with clinical examination and laboratory tests as well as a thorough angiographic evaluation. TARE is safe and effective in the treatment of unresectable HCC, as it has longer time-to-progression, greater ability to downsize tumors for liver transplantation, less post-embolization syndrome, and shorter hospitalization compared with chemoembolization. TARE can also serve as an alternative to ablation, surgical resection, portal vein embolization, and sorafenib. The utility of TARE continues to expand with new insights in interventional oncology.

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Outcomes of Radioembolization in the Treatment of Hepatocellular Carcinoma with Portal Vein Invasion: Resin versus Glass Microspheres

Cited by 48 publications

References 26 publications

Institutional decision to adopt Y90 as primary treatment for hepatocellular carcinoma informed by a 1,000‐patient 15‐year experience

Institutional decision to adopt Y90 as primary treatment for hepatocellular carcinoma informed by a 1,000‐patient 15‐year experience

Resin Versus Glass Microspheres for ⁹⁰Y Transarterial Radioembolization: Comparing Survival in Unresectable Hepatocellular Carcinoma Using Pretreatment Partition Model Dosimetry

Radioembolization for the treatment of hepatocellular carcinoma

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Outcomes of Radioembolization in the Treatment of Hepatocellular Carcinoma with Portal Vein Invasion: Resin versus Glass Microspheres

Cited by 48 publications

References 26 publications

Institutional decision to adopt Y90 as primary treatment for hepatocellular carcinoma informed by a 1,000‐patient 15‐year experience

Institutional decision to adopt Y90 as primary treatment for hepatocellular carcinoma informed by a 1,000‐patient 15‐year experience

Resin Versus Glass Microspheres for 90Y Transarterial Radioembolization: Comparing Survival in Unresectable Hepatocellular Carcinoma Using Pretreatment Partition Model Dosimetry

Radioembolization for the treatment of hepatocellular carcinoma

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Resin Versus Glass Microspheres for ⁹⁰Y Transarterial Radioembolization: Comparing Survival in Unresectable Hepatocellular Carcinoma Using Pretreatment Partition Model Dosimetry