title: Resin Versus Glass Microspheres for90Y Transarterial Radioembolization: Comparing Survival in Unresectable Hepatocellular Carcinoma Using Pretreatment Partition Model Dosimetry.
abstract: The aim of this study was to compare survival of patients treated for unresectable hepatocellular carcinoma (uHCC) with90Y transarterial radioembolization (TARE) using pretreatment partition model dosimetry (PMD).Methods:We performed a retrospective analysis of prospectively collected data on 77 patients consecutively treated (mean age ± SD, 66.4 ± 12.2 y) for uHCC (36 uninodular, 5 multinodular, 36 diffuse) with90Y TARE (41 resin, 36 glass) using pretreatment PMD. Study endpoints were progression-free survival (PFS) and overall survival (OS) assessed by Kaplan-Meier estimates. Several variables including Barcelona Clinic Liver Cancer (BCLC) staging system, tumor size, and serum α-fetoprotein (AFP) level were investigated using Cox proportional hazards regression.Results:The characteristics of 2 groups were comparable with regard to demographic data, comorbidities, Child-Pugh score, BCLC, serum AFP level, and90Y global administered activity. The median follow-up time was 7.7 mo (range, 0.4-50.1 mo). Relapse occurred in 44 patients (57%) at a median of 6 mo (range, 0.4-27.9 mo) after90Y TARE, and 41 patients (53%) died from tumor progression. Comparison between resin and glass microspheres revealed higher but not statistically significantly PFS and OS rates in the90Y resin group than the90Y glass group (resin PFS 6.1 mo [95% confidence interval CI, 4.7-7.4] and glass PFS 5 mo [95% CI, 0.9-9.2],P= 0.53; resin OS 7.7 mo [95% CI, 7.2-8.2] and glass OS 7 mo [95% CI 1.6-12.4],P= 0.77). No significant survival difference between both types of90Y microspheres was observed in any subgroups of patients with early/intermediate or advanced BCLC stages. Among the variables investigated, Cox analyses showed that only in the glass group, the BCLC staging system and the serum AFP level were associated with PFS (P= 0.04) and OS (P= 0.04). Tumor size was a prognostic factor without significant influence on PFS and OS after90Y TARE.Conclusion:Comparison between resin and glass microspheres revealed no significant survival difference in patients treated for uHCC with90Y TARE using pretreatment PMD. Further, larger prospective studies are warranted to confirm these findings.
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Axel
authors.initials: A
authors.lastname: Van Der Gucht
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Mario
authors.initials: M
authors.lastname: Jreige
authors.affiliation: Department of Radiology and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; and alban.denys@chuv.ch.
authors.forename: Alban
authors.initials: A
authors.lastname: Denys
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Paul
authors.initials: P
authors.lastname: Blanc-Durand
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Ariane
authors.initials: A
authors.lastname: Boubaker
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Pomoni
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Periklis
authors.initials: P
authors.lastname: Mitsakis
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Marina
authors.initials: M
authors.lastname: Silva-Monteiro
authors.affiliation: Institute of Radiation Physics, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Silvano
authors.initials: S
authors.lastname: Gnesin
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Marie Nicod
authors.initials: MN
authors.lastname: Lalonde
authors.affiliation: Department of Radiology and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland; and.
authors.forename: Rafael
authors.initials: R
authors.lastname: Duran
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: John O
authors.initials: JO
authors.lastname: Prior
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Niklaus
authors.initials: N
authors.lastname: Schaefer
mesh_terms: D000180:Acrylic Resins / Q000737:chemistry*; D001158:Arteries; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005898:Glass / Q000737:chemistry*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011874:Radiometry; D012189:Retrospective Studies; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D000180:Acrylic Resins; D015021:Yttrium Radioisotopes
keywords: 90Y; TARE; hepatocellular carcinoma; partition model dosimetry; survival