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radioembolization hcc

Philippe d'Abadie, Michel Hesse, Francois Jamar, Renaud Lhommel, Stephan Walrand
Clinical studies reported a twofold ratio between the efficacies per Gy of resin versus glass spheres. Our aim is to investigate whether this difference could result from the different degrees of heterogeneity in sphere distribution between the two medical devices. The 90Y TOF-PET based equivalent uniform doses (EUD) was used for this purpose.
 Method: 58 consecutive HCC radioembolizations were retrospectively analyzed. Absorbed doses D and Jones-Hoban EUD in lesions were computed. Radioembolization efficacy was assessed using Kaplan-Meier survival curves...
November 19, 2018: Physics in Medicine and Biology
Pedro L Esquinas, Ajit Shinto, Koramadai K Kamaleshwaran, Jephy Joseph, Anna Celler
BACKGROUND: Rhenium-188-labelled-Lipiodol radioembolization is a safe and cost-effective treatment for primary liver cancer. In order to determine correlations between treatment doses and patient response to therapy, accurate patient-specific dosimetry is required. Up to date, the reported dosimetry of 188 Re-Lipiodol has been based on whole-body (WB) planar imaging only, which has limited quantitative accuracy. The aim of the present study is to determine the in vivo pharmacokinetics, bio-distribution, and organ-level dosimetry of 188 Re-AHDD-Lipiodol radioembolization using a combination of post-treatment planar and quantitative SPECT/CT images...
December 7, 2018: EJNMMI Physics
Homan Mohammadi, Yazan Abuodeh, William Jin, Jessica Frakes, Mark Friedman, Benjamin Biebel, Junsung Choi, Ghassan El-Haddad, Bela Kis, Jennifer Sweeney, Sarah Hoffe
Background: The Child-Pugh (CP) class is a commonly used scoring system to measure liver function in patients with hepatocellular carcinoma (HCC). We correlate the Albumin-Bilirubin (ALBI) grading system and CP to overall survival in our HCC patients receiving radioembolization. Methods: We retrospectively evaluated patients who received radioembolization for HCC between the years 2009-2014. We evaluated the albumin and bilirubin levels in our patients prior to receiving their first (n=124) radioembolization...
October 2018: Journal of Gastrointestinal Oncology
Andrea Casadei Gardini, Emiliano Tamburini, Mercedes Iñarrairaegui, Giovanni Luca Frassineti, Bruno Sangro
Purpose: This study aimed to compare clinically relevant outcomes following transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) in patients with unresectable hepatocellular carcinoma (HCC) using only prospective randomized clinical trials as a source of information. Materials and methods: A meta-analysis was performed to compare the efficacy of TARE and TACE in treating patients with unresectable HCC. Only prospective randomized trials were included in the quantitative analysis...
2018: OncoTargets and Therapy
Remco Bastiaannet, S Cheenu Kappadath, Britt Kunnen, Arthur J A T Braat, Marnix G E H Lam, Hugo W A M de Jong
Radioembolization is an established treatment for chemoresistant and unresectable liver cancers. Currently, treatment planning is often based on semi-empirical methods, which yield acceptable toxicity profiles and have enabled the large-scale application in a palliative setting. However, recently, five large randomized controlled trials using resin microspheres failed to demonstrate a significant improvement in either progression-free survival or overall survival in both hepatocellular carcinoma and metastatic colorectal cancer...
November 2, 2018: EJNMMI Physics
T Kirchner, S Marquardt, T Werncke, M M Kirstein, T Brunkhorst, F Wacker, A Vogel, Thomas Rodt
PURPOSE: The purpose of this study was to compare quality of life (QoL) after two different transarterial therapies [transarterial chemoembolization (TACE) and transarterial radioembolization (TARE)] for patients with unresectable hepatocellular carcinoma (HCC) to assess tumor therapy in palliative situation additional to traditional aims like survival or image response. MATERIAL AND METHODS: QoL was evaluated with two validated questionnaires (EORTC QLQ-30 and EORTC HCC18) before and 14d after treatment in 94 initial therapies (TACE n = 67; TARE n = 27)...
October 11, 2018: Abdominal Radiology
Diego A S Toesca, Aisling Barry, Gonzalo Sapisochin, Robert Beecroft, Laura Dawson, Dawn Owen, Samdeep Mouli, Robert Lewandowski, Riad Salem, Daniel T Chang
Surgical resection or liver transplantation offers the best chance of cure for patients with hepatocellular carcinoma (HCC). Unfortunately, most patients are not good candidates for liver resection due to locally advanced disease or compromised liver function. Moreover, liver transplantation waiting lists are long. For those cases not amenable for resection, a variety of local treatment modalities are available, such as image-guided ablative procedures, transarterial chemoembolization, and radioembolization, as well as external beam radiation...
October 2018: Seminars in Radiation Oncology
Hyo-Cheol Kim, Yoon Jun Kim, Jeong-Hoon Lee, Kyung-Suk Suh, Jin Wook Chung
PURPOSE: To address the feasibility of yttrium-90 (90 Y) glass microspheres administered at a boosted dose in large hepatocellular carcinomas (HCCs). MATERIALS AND METHODS: From July 2016 to August 2017, 20 patients who underwent 90 Y radioembolization for treatment-naïve HCC met the following inclusion criteria: (i) nodular tumor, (ii) tumor size > 5 cm, (iii) Barcelona Clinic Liver Cancer stage A/B disease, (iv) target perfused tissue dose > 150 Gy, and (v) all tumors treated in 1 session of radioembolization...
October 4, 2018: Journal of Vascular and Interventional Radiology: JVIR
Lindsay M Thornton, Brian S Geller, Eric W Pepin, Jehan L Shah, Melissa Kapp, Beau B Toskich
PURPOSE: To retrospectively analyze adverse events (AE) in patients with hepatocellular carcinoma (HCC) treated with yttrium-90 radioembolization in the setting of angiographically apparent arterioportal shunts (APSs). MATERIALS AND METHODS: Thirty-two patients with HCC underwent radioembolization with APSs from January 2011 to September 2016, totaling 34 administrations using resin (6) and glass (28) microspheres. APSs were graded angiographically as segmental (9), ipsilobar (15), contralobar (7), or main portal (2), according to portal perfusion...
November 2018: Journal of Vascular and Interventional Radiology: JVIR
Ahmed Gabr, Nadine Abouchaleh, Rehan Ali, Talia Baker, Juan Caicedo, Nitin Katariya, Michael Abecassis, Ahsun Riaz, Robert J Lewandowski, Riad Salem
PURPOSE: To longitudinally study clinical and radiologic outcomes of patients with hepatocellular carcinoma (HCC) who underwent yttrium-90 transarterial radioembolization (TARE) as a bridge to surgical resection. MATERIALS AND METHODS: TARE was performed in 31 patients with HCC before resection. Of patients, 25 underwent major hepatic resection (16 received right hepatectomy and 9 received trisegmentectomy), and 6 underwent partial hepatectomy. Clinical outcomes after TARE and after resection were recorded...
November 2018: Journal of Vascular and Interventional Radiology: JVIR
Carole Allimant, Marilyne Kafrouni, Julien Delicque, Diana Ilonca, Christophe Cassinotto, Eric Assenat, Jose Ursic-Bedoya, Georges-Philippe Pageaux, Denis Mariano-Goulart, Serge Aho, Boris Guiu
PURPOSE: To identify predictive factors of tumor response, progression-free survival (PFS), overall survival (OS), and toxicity using three-dimensional (3D) voxel-based dosimetry in patients with intermediate and advanced stage hepatocellular carcinoma (HCC) treated by yttrium-90 (90 Y) resin microspheres radioembolization (RE). MATERIALS AND METHODS: From February 2012 to December 2015, 45 90 Y resin microspheres RE procedures were performed for HCC (Barcelona Clinic Liver Cancer stage B/C; n = 15/30)...
September 11, 2018: Journal of Vascular and Interventional Radiology: JVIR
Ze-Feng Zhang, Yu-Jun Luo, Quan Lu, Shi-Xue Dai, Wei-Hong Sha
AIM: To review the conversion therapy for initially unresectable hepatocellular carcinoma (HCC) patients and the suitable timing for subsequent salvage surgery. METHODS: A PubMed search was undertaken from 1987 to 2017 to identify articles using the keywords including "unresectable" "hepatocellular carcinoma", "hepatectomy", "conversion therapy", "resection", "salvage surgery" and "downstaging"...
September 6, 2018: World Journal of Clinical Cases
Alberta Cappelli, Paloma Sangro, Cristina Mosconi, Iris Deppe, Eleonora Terzi, Jose I Bilbao, Macarena Rodriguez-Fraile, Caterina De Benedittis, Jens Ricke, Rita Golfieri, Bruno Sangro
PURPOSE: Patients with hepatocellular carcinoma (HCC) of intermediate stage (BCLC-B according to the Barcelona Clinic Liver Cancer classification) are a heterogeneous group with different degrees of liver function impairment and tumour burden. The recommended treatment is transarterial chemoembolization (TACE). However, patients in this group may be judged as poor candidates for TACE because the risk-benefit ratio is low. Such patients may receive transarterial radioembolization (TARE) only by entering a clinical trial...
September 12, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Yi Yang, Tongguo Si
Objective: To compare the effects and safety of conventional transarterial chemoembolization (cTACE) and yttrium-90 transarterial radioembolization [TARE (90Y)] for hepatocellular carcinoma (HCC). Methods: Nine high-quality observational studies, one low bias-risk randomized controlled trial (RCT), and one moderate bias-risk RCT included 1,652 patients [cTACE, 1,124; TARE (90Y), 528], from whom data were extracted for this systematic review and meta-analysis. Results: The extracted study outcomes included 1-year and 2-year overall survival (OS) rates, objective responses (ORs), and serious adverse events (AEs)...
August 2018: Cancer Biology & Medicine
S Cheenu Kappadath, Justin Mikell, Anjali Balagopal, Veera Baladandayuthapani, Ahmed Kaseb, Armeen Mahvash
PURPOSE: To investigate hepatocellular carcinoma tumor dose-response characteristics based on voxel-level absorbed doses (D) and biological effective doses (BED) using quantitative 90 Y-single-photon emission computed tomography (SPECT)/computed tomography (CT) after 90 Y-radioembilization with glass microspheres. We also investigated the relationship between normal liver D and toxicities. METHODS AND MATERIALS: 90 Y-radioembolization activity distributions for 34 patients were based on quantitative 90 Y-bremsstrahlung SPECT/CT...
October 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Nikhil Chauhan, Janet Bukovcan, Eveline Boucher, David Cosgrove, Julien Edeline, Bonnie Hamilton, Laura Kulik, Fayaz Master, Riad Salem
BACKGROUND: Globally, hepatocellular carcinoma is the second most common cause of cancer deaths. It remains challenging to intensify cancer treatment without impairing liver function. OBJECTIVE: The objective of the TheraSphere in the Treatment of Patients with Unresectable Hepatocellular Carcinoma (STOP-HCC) study is to examine the hypothesis that transarterial radioembolization (TheraSphere yttrium-90 glass microspheres) combined with standard first-line treatment with sorafenib will improve outcomes over treatment with sorafenib alone in unresectable hepatocellular carcinoma...
August 15, 2018: JMIR Research Protocols
Francisco Tustumi, Lucas Ernani, Fabricio F Coelho, Wanderley M Bernardo, Sérgio S Junior, Jaime A P Kruger, Gilton M Fonseca, Vagner B Jeismann, Ivan Cecconello, Paulo Herman
BACKGROUND: Preoperative strategies to increase the future liver remnant are useful methods to improve resectability rates for patients with hepatocellular carcinoma (HCC). The aim of this study was to perform a systematic review and meta-analysis of the main strategies used for this purpose. METHODS: A systematic review was performed in PubMed, EMBASE, Cochrane and Scielo/LILACS. The procedures included for analysis were portal vein embolization or ligation (PVE/PVL), sequential transarterial embolization and PVE (TACE + PVE), radioembolization (RE) and associated liver partition and portal vein ligation for staged hepatectomy (ALPPS)...
December 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Jessica M Frakes, Yazan A Abuodeh, Arash O Naghavi, Michelle I Echevarria, Ravi Shridhar, Mark Friedman, Richard Kim, Ghassan El-Haddad, Bela Kis, Benjamin Biebel, Jennifer Sweeney, Junsung Choi, Daniel Anaya, Anna R Giuliano, Sarah E Hoffe
Background: Viral associated (VA) malignancies have recently been correlated with improved outcomes. We sought to evaluate outcomes of patients with hepatocellular carcinoma (HCC) with and without viral hepatitis (hepatitis B and C) treated with lobar yttrium-90 radioembolization (Y-90 RE). Methods: After IRB approval, an institutional database of patients with HCC who received RE between 2009-2014 was queried and 99 patients were identified that received a total of 122 lobar RE...
June 2018: Journal of Gastrointestinal Oncology
Carla Rognoni, Oriana Ciani, Silvia Sommariva, Irene Bargellini, Sherrie Bhoori, Roberto Cioni, Antonio Facciorusso, Rita Golfieri, Annagiulia Gramenzi, Vincenzo Mazzaferro, Cristina Mosconi, Francesca Ponziani, Rodolfo Sacco, Franco Trevisani, Rosanna Tarricone
BACKGROUND: Trans-arterial radio-embolization (TARE) is an emerging treatment for the management of hepatocellular carcinoma (HCC). TARE may compete with systemic chemotherapy, sorafenib, in intermediate stage patients with prior chemoembolization failure or advanced patients with tumoral macrovascular invasion with no extra-hepatic spread and good liver function. We performed a budget impact analysis (BIA) evaluating the expected changes in the expenditure for the Italian Healthcare Service within scenarios of increased utilization of TARE in place of sorafenib over the next five years...
July 5, 2018: BMC Cancer
Peter S Potrebko, Ravi Shridhar, Matthew C Biagioli, William F Sensakovic, George Andl, Jan Poleszczuk, Timothy H Fox
This work demonstrates the efficacy of voxel-based 90 Y microsphere dosimetry utilizing post-therapy SPECT/CT imaging and applies it to the prediction of treatment response for the management of patients with hepatocellular carcinoma (HCC). A 90 Y microsphere dosimetry navigator (RapidSphere) within a commercial platform (Velocity, Varian Medical Systems) was demonstrated for three microsphere cases that were imaged using optimized bremsstrahlung SPECT/CT. For each case, the 90 Y SPECT/CT was registered to follow-up diagnostic MR/CT using deformable image registration...
September 2018: Journal of Applied Clinical Medical Physics
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