title: Survival benefit of radioembolization for inoperable hepatocellular carcinoma using yttrium-90 microspheres.
abstract: OBJECTIVE
  Transarterial radioembolization with yttrium-90 microspheres is one treatment option for inoperable hepatocellular carcinoma. We compared the survival in a cohort of patients receiving radioembolization or no radioembolization.
  
  
  METHODS
  The data of 46 patients referred for radioembolization was retrospectively reviewed. The patient, tumor characteristics, and the survival were compared in the two groups. The independent predictors for survival were studied with multivariate analysis. The side-effects and the complication of radioembolization-induced liver disease was recorded.
  
  
  RESULTS
  Thirty patients received radioembolization; 16 patients did not. The two groups did not differ in the mean age, Child-Pugh classes, Barcelona Clinic of Liver Cancer (BCLC) stages, tumor types, sum of diameter of the two biggest tumors, and extent of portal vein invasion. Those with BCLC stage C tumor, with portal vein thrombus, or with less than three nodules had significantly longer survival after radioembolization. There was a trend of longer survival in patients with Child-Pugh A liver function, or with BCLC stage B tumor after radioembolization. The median survival was more than 31.9 months, 14.5 months, and 5.2 months in patients with BCLC stage A, B, and C tumors. The independent predictors for longer survival were Child-Pugh class, tumor diameter sum, BCLC stage, and receiving radioembolization. Grade 2 irradiation-induced gastritis occurred in three patients (10%). Radioembolization-induced liver disease occurred in four patients (13%).
  
  
  CONCLUSIONS
  Radioembolization may prolong survival for patients with inoperable hepatocellular carcinoma. Radioembolization-induced liver disease occurred and should be further studied.
authors.affiliation: Department of Radiology and Imaging, Queen Elizabeth Hospital, Hong Kong.
authors.forename: Philip Chong-Hei
authors.initials: PC
authors.lastname: Kwok
authors.forename: Kwong Chuen
authors.initials: KC
authors.lastname: Leung
authors.forename: Moon Tong
authors.initials: MT
authors.lastname: Cheung
authors.forename: Ting Wa
authors.initials: TW
authors.lastname: Lam
authors.forename: Lok Tin
authors.initials: LT
authors.lastname: Szeto
authors.forename: Sandas Qi-Hua
authors.initials: SQ
authors.lastname: Chou
authors.forename: Nam Hung
authors.initials: NH
authors.lastname: Chia
authors.forename: Cheuk Man
authors.initials: CM
authors.lastname: Tong
authors.forename: Pui Kei
authors.initials: PK
authors.lastname: Yuen
authors.forename: Chun Hung
authors.initials: CH
authors.lastname: Cheung
authors.forename: Chun Key
authors.initials: CK
authors.lastname: Law
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D009367:Neoplasm Staging; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes
keywords: analysis; hepatocellular carcinoma; isotopes; radiation-induced abnormality; survival; treatment; yttrium