Transarterial Y90 radioembolization versus chemoembolization for patients with hepatocellular carcinoma: A meta-analysis

Zhang, Yafei; Li, Yiming; Ji, Hong; Zhao, Xin; Lü, Hongwei

doi:10.5582/bst.2015.01089

Cited by 55 publications

(40 citation statements)

References 38 publications

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“…The observed pooled progression probability was 56% at 1 year and 73% at 2 years after therapy [55]. Another meta-analysis of eight studies involving 1499 patients reported significantly longer overall survival and time to progression with 90 Y SIRT than with transarterial chemoembolization in patients with HCC, although the latter may be preferred in patients with low hepatic reserve who are candidates for liver transplant [56]. Similar favorable pooled outcome results have been reported with systematic review and meta-analysis of data on unresectable intrahepatic cholangiocarcinoma and meta-static NETs [57, 58].…”

Section: Selective Internal Radioembolization Of Malignant Liver Lesionsmentioning

confidence: 99%

Targeted Radionuclide Therapy: An Evolution Toward Precision Cancer Treatment

Jadvar

2017

American Journal of Roentgenology

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Objective This article reviews recent developments in targeted radionuclide therapy (TRT) approaches directed to malignant liver lesions, bone metastases, neuroendocrine tumors, and castrate-resistant metastatic prostate cancer and discusses challenges and opportunities in this field. Conclusion TRT has been employed since the first radioiodine thyroid treatment almost 75 years ago. Progress in the understanding of the complex underlying biology of cancer and advances in radiochemistry science, multimodal imaging techniques including the concept of “see and treat” within the framework of theranostics, and universal traction with the notion of precision medicine have all contributed to a resurgence of TRT.

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Section: Selective Internal Radioembolization Of Malignant Liver Lesionsmentioning

confidence: 99%

Targeted Radionuclide Therapy: An Evolution Toward Precision Cancer Treatment

Jadvar

2017

American Journal of Roentgenology

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“…In the radioembolization procedure, microspheres bonded with a radioisotope (yttrium-90 [Y-90]) are infused into the arteries that supply the tumor. 15,23 Retrospective reviews have reported comparable or improved OS with TARE versus TACE, [24][25][26] and a randomized trial reported a significantly longer median time to progression after TARE (>26 vs 6.8 months) but no difference in OS. 19 On the basis of liver explant pathology after radioembolization and subsequent transplantation, 61% of treated lesions (and 89% of lesions <3 cm) exhibited complete pathologic necrosis.…”

Section: Radioembolizationmentioning

confidence: 99%

The role of external beam radiotherapy in the treatment of hepatocellular cancer

Chino

Stephens

Marin

et al. 2018

Cancer

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Hepatocellular carcinoma (HCC) is increasing in incidence and mortality. Although the prognosis remains poor, long-term survival has improved from 3% in 1970 to an 18% 5-year survival rate today. This is likely because of the introduction of well tolerated, oral antiviral therapies for hepatitis C. Curative options for patients with HCC are often limited by underlying liver dysfunction/cirrhosis and medical comorbidities. Less than one-third of patients are candidates for surgery, which is the current gold standard for cure. Nonsurgical treatments include embolotherapies, percutaneous ablation, and ablative radiation. Technological advances in radiation delivery in the past several decades now allow for safe and effective ablative doses to the liver. Conformal techniques allow for both dose escalation to target volumes and normal tissue sparing. Multiple retrospective and prospective studies have demonstrated that hypofractionated image-guided radiation therapy, used as monotherapy or in combination with other liver-directed therapies, can provide excellent local control that is cost effective. Therefore, as the HCC treatment paradigm continues to evolve, ablative radiation treatment has moved from a palliative treatment to both a "bridge to transplant" and a definitive treatment.

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“…Recently, new approaches have been introduced as either standard minimally invasive procedures or adjuvant therapies in order to improve the survival status of HCC patients: yttrium-90 radioembolization (TARE-90Y), radiotherapy (RT), percutaneous acetic acid injection (PAI), external-beam radiation therapy (EBRT), drug-eluting beads-transcatheter arterial chemoembolization (DEB-TACE), percutaneous ethanol injection (PEI) and sorafenib (SOR) [8–13]. Studies in the current literature suggest that standard minimally invasive procedures in combination with adjuvant therapies may be more efficacious than monotherapy.…”

Section: Introductionmentioning

confidence: 99%

Comparing the long-term efficacy of standard and combined minimally invasive procedures for unresectable HCC: a mixed treatment comparison

et al. 2016

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A small proportion of hepatocellular carcinoma (HCC) patients are suitable for surgical resections and various minimally invasive procedures have been introduced as alternatives to surgical resections. However, the relative efficacy of minimally invasive procedures remains to be studied in the current literature. Several popular minimally invasive procedures (monotherapy or combined therapies) were selected for comparison and their relative long-term efficacy were determined by using the statistics of hazard ratio (HR) which evaluates the survival status of HCC patients in one, two, three and four years, respectively. Evidence were obtained from the current literature and synthesized by using the approach of conventional pairwise meta-analysis and network meta-analysis (NMA). Moreover, selected minimally invasive procedures were ranked according to their surface under the cumulative ranking curve (SUCRA) which was produced by NMA in conjunction with the Markov Chain Monte Carlo (MCMC) sampling method. HCC patients treated by combined minimally invasive procedures, particularly transcatheter arterial chemoembolization (TACE) + high intensity focused ultrasound (HIFU), TACE + radiofrequency ablation (RFA), TACE + radiotherapy (RT) and TACE + Sorafenib (SOR) exhibited a significant decrease in the HR compared to those with standard TACE (HR < 1). The combined minimally invasive procedure of TACE + HIFU appears to be the most preferable therapy. PEI seems to be less favorable than other minimally invasive procedures. Combined minimally invasive procedures may be more preferable than standard minimally invasive procedures. Percutaneous ethanol injection (PEI) may not provide adequate efficacy compared to other minimally invasive procedures for unresectable HCC patients.

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Transarterial Y90 radioembolization versus chemoembolization for patients with hepatocellular carcinoma: A meta-analysis

Cited by 55 publications

References 38 publications

Targeted Radionuclide Therapy: An Evolution Toward Precision Cancer Treatment

Targeted Radionuclide Therapy: An Evolution Toward Precision Cancer Treatment

The role of external beam radiotherapy in the treatment of hepatocellular cancer

Comparing the long-term efficacy of standard and combined minimally invasive procedures for unresectable HCC: a mixed treatment comparison

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