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Objective <p>To evaluate tumor dose (TD) as a predictor of oncological outcomes in patients with hepatocellular carcinoma (HCC) treated with resin Y90 radioembolization (RE), and to evaluate non-tumoral liver dose (NTLD) as a predictor of treatment-related toxicity.</p> Methods <p>A single-center retrospective review of treatment-naïve HCC patients who underwent resin-based Y90 between 2019 and 2022 was conducted. Baseline demographics, clinical history, and adverse events per CTCAE v5.0 were analyzed. Baseline imaging and post-treatment imaging were also evaluated using Response per Modified Response Evaluation Criteria in Solid Tumors (mRECIST) for tumor response.</p> Results <p>78 patients (mean age:66.7 years) with 91 tumors underwent Y90-RE, with a median follow-up period of 28.3 months; 23 received lobar Y90-RE, while 55 patients received segmentectomies. Mean TD for the entire cohort was 336.6 ± 291.9 Gy. Mean TD was significantly higher in segmental Y90-RE (424.3 Gy) vs lobar Y90-RE (203.7 Gy) (<i>p</i> &lt; 0.001). At 3 months, 98% of segmentectomy and 72% of lobar patients achieved an objective response (OR), with 90% and 40% achieving complete response (CR), respectively. At 6 months, 97% and 94% of segmentectomy patients achieved OR and CR, compared to 84% and 68% in lobar patients. Mean tumor dose &gt; 250 Gy predicted prolonged overall and progression free survival. A mean NTLD dose of 103 Gy predicted grade 3 + adverse events in lobar treatments.</p> Conclusion <p>In patients with HCC treated with resin-based Y90-RE, personalized dosimetry is a key factor in ensuring favorable oncological outcomes.</p> <p><i>Level of evidence</i> Level 3b, retrospective cohort study.</p> Graphical abstract <p></p>

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Tumor Dose as an Oncologic Predictor of Outcome in Patients with HCC Treated with Resin Y90 Microspheres

  • 期刊论文

  • 发表日期：

    2025年7月10日

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  • Howard Dabbous,
  • Sandra Gad,
  • Michael Mohnasky,
  • Alex Villalobos,
  • David Brandon,
  • Minzhi Xing,
  • Nima Kokabi

摘要

Objective

To evaluate tumor dose (TD) as a predictor of oncological outcomes in patients with hepatocellular carcinoma (HCC) treated with resin Y90 radioembolization (RE), and to evaluate non-tumoral liver dose (NTLD) as a predictor of treatment-related toxicity.

Methods

A single-center retrospective review of treatment-naïve HCC patients who underwent resin-based Y90 between 2019 and 2022 was conducted. Baseline demographics, clinical history, and adverse events per CTCAE v5.0 were analyzed. Baseline imaging and post-treatment imaging were also evaluated using Response per Modified Response Evaluation Criteria in Solid Tumors (mRECIST) for tumor response.

Results

78 patients (mean age:66.7 years) with 91 tumors underwent Y90-RE, with a median follow-up period of 28.3 months; 23 received lobar Y90-RE, while 55 patients received segmentectomies. Mean TD for the entire cohort was 336.6 ± 291.9 Gy. Mean TD was significantly higher in segmental Y90-RE (424.3 Gy) vs lobar Y90-RE (203.7 Gy) (p < 0.001). At 3 months, 98% of segmentectomy and 72% of lobar patients achieved an objective response (OR), with 90% and 40% achieving complete response (CR), respectively. At 6 months, 97% and 94% of segmentectomy patients achieved OR and CR, compared to 84% and 68% in lobar patients. Mean tumor dose > 250 Gy predicted prolonged overall and progression free survival. A mean NTLD dose of 103 Gy predicted grade 3 + adverse events in lobar treatments.

Conclusion

In patients with HCC treated with resin-based Y90-RE, personalized dosimetry is a key factor in ensuring favorable oncological outcomes.

Level of evidence Level 3b, retrospective cohort study.

Graphical abstract