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Purpose <p>To report outcomes in hepatocellular carcinoma (HCC) patients with lobar and segmental vascular invasion treated with resin Yttrium-90 transarterial radioembolization (Y90-TARE) with single-compartment MIRD (Medical Internal Radiation Dose) model.</p> Materials and Methods <p>This was a retrospective IRB approved study of patients with a diagnosis of HCC with vascular invasion undergoing resin Y90-TARE from 2014 to 2022 (n = 61). Patients with Body Surface Area dosimetry (n = 20), main portal vein invasion (n = 6) and patients with an ECOG of &gt; 2 were excluded (n = 1) with a final cohort of 34 patients.</p> Results <p>Study population consisted of 34 patients, median age 62&#xa0;years [60–71], tumor size 4.2 (2.8–7.4) cm, and 82% male. The median prescribed dose was 170 (126–200) Gy. The objective response rate at 6&#xa0;months was 67% and disease control rate was 72%. The median survival was 18&#xa0;months, median progression-free survival was 9.8&#xa0;months. The 1- and 3-year survival rates were 76% and 57% in patients prescribed &gt; 180&#xa0;Gy, compared to 29% and 15% in patients with &lt; 180&#xa0;Gy (<i>p</i> = 0.01). Five of 15 Childs-Pugh A, ECOG &lt; 1 patients (33%) were downstaged to resection, with complete pathologic necrosis in 40%, and 1 and 3-year survival rates of 100%. Grade-3 adverse events were seen in only 5/34 (15%), with no grade-4 or 5 adverse events.</p> Conclusion <p>Resin Y90-TARE using single compartment MIRD model for HCC with segmental and lobar vascular invasion can result in downstaging to resection in 33% of patients and higher prescribed doses (&gt; 180&#xa0;Gy) result in improved survival.</p> Graphical Abstract <p></p>

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Hepatocellular Carcinoma with Vascular Invasion Treated with Resin Yttrium-90 Transarterial Radioembolization Using Single Compartment Dosimetry

  • 期刊论文

  • 发表日期：

    2025年1月14日

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  • Muhammad Mohid Tahir,
  • Aamir Ali,
  • Imad Nasser,
  • Diana C. Dinh,
  • Andreea M. Catana,
  • Andrea Bullock,
  • Michael P. Curry,
  • Devin Eckhoff,
  • Jeffrey L. Weinstein,
  • Muneeb Ahmed,
  • Ammar Sarwar

摘要

Purpose

To report outcomes in hepatocellular carcinoma (HCC) patients with lobar and segmental vascular invasion treated with resin Yttrium-90 transarterial radioembolization (Y90-TARE) with single-compartment MIRD (Medical Internal Radiation Dose) model.

Materials and Methods

This was a retrospective IRB approved study of patients with a diagnosis of HCC with vascular invasion undergoing resin Y90-TARE from 2014 to 2022 (n = 61). Patients with Body Surface Area dosimetry (n = 20), main portal vein invasion (n = 6) and patients with an ECOG of > 2 were excluded (n = 1) with a final cohort of 34 patients.

Results

Study population consisted of 34 patients, median age 62 years [60–71], tumor size 4.2 (2.8–7.4) cm, and 82% male. The median prescribed dose was 170 (126–200) Gy. The objective response rate at 6 months was 67% and disease control rate was 72%. The median survival was 18 months, median progression-free survival was 9.8 months. The 1- and 3-year survival rates were 76% and 57% in patients prescribed > 180 Gy, compared to 29% and 15% in patients with < 180 Gy (p = 0.01). Five of 15 Childs-Pugh A, ECOG < 1 patients (33%) were downstaged to resection, with complete pathologic necrosis in 40%, and 1 and 3-year survival rates of 100%. Grade-3 adverse events were seen in only 5/34 (15%), with no grade-4 or 5 adverse events.

Conclusion

Resin Y90-TARE using single compartment MIRD model for HCC with segmental and lobar vascular invasion can result in downstaging to resection in 33% of patients and higher prescribed doses (> 180 Gy) result in improved survival.

Graphical Abstract