title: Prognostic factors for prediction of survival of hepatocellular cancer patients after selective internal radiation therapy.
abstract: OBJECTIVE
  In this study, it was aimed to explore the prognostic factors in patients who received selective internal radiation therapy for hepatocellular cancer.
  
  
  METHODS
  A retrospective evaluation was made of 28 (24 male, 4 female, mean age 65.4 ± 6.8 years) hepatocellular cancer patients who received selective internal radiation therapy with Y-90 resin microspheres. Using Cox proportional hazards regression analysis, the relationship between age, gender, MELD score, serum albumin and AFP levels, number of liver lesions, size of the largest lesion, absence of (18)F-FDG uptake, maximum standardized uptake value and overall survival times was analyzed.
  
  
  RESULTS
  Treatment was applied to the right lobe in 22 and both in 6 patients. Mean treatment dose was 1.5 ± 0.2 GBq. Number of liver lesions were 1, <5 and multiple in 16, 5 and 7 patients, respectively, and the mean size of the largest lesion was 41.5 mm (min-max 15-160 mm). While (18)F-FDG uptake was seen in 24 patients, liver lesions were hypometabolic in 4 patients. Mean SUVmax of liver lesions was calculated as 5.3 ± 0.3. During the mean 17.8 (min-max 2-39) months follow-up period, 19 patients died. Median survival time was computed as 18 ± 5 months (95% CI 8.1-27.8). Age (p = 0.04), serum AFP level (p = 0.03) and size of the largest lesion (p = 0.02) had a significant negative effect on survival according to the Cox proportional hazards regression analysis.
  
  
  CONCLUSIONS
  Age, serum AFP level and the size of the largest liver lesion have a negative significant effect on survival of hepatocellular cancer patients who received selective internal radiation therapy.
authors.affiliation: Department of Nuclear Medicine, Ankara University Medical Faculty, Cebeci, Ankara, 06590, Turkey, csoydal@yahoo.com.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Soydal
authors.forename: Onur
authors.initials: O
authors.lastname: Keskin
authors.forename: Ozlem N
authors.initials: ON
authors.lastname: Kucuk
authors.forename: Elgin
authors.initials: E
authors.lastname: Ozkan
authors.forename: Sadik
authors.initials: S
authors.lastname: Bilgic
authors.forename: Ramazan
authors.initials: R
authors.lastname: Idilman
authors.forename: Metin K
authors.initials: MK
authors.lastname: Kir
mesh_terms: D000367:Age Factors; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology / Q000528:radiation effects; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
chemical_list: D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals; D012709:Serum Albumin; D015021:Yttrium Radioisotopes; D019788:Fluorodeoxyglucose F18