title: Comparison of the Adverse Event Profile of TheraSphere®with SIR-Spheres®for the Treatment of Unresectable Hepatocellular Carcinoma: A Systematic Review.
abstract: To compare the safety profiles of TheraSphere®(glass) and SIR-Spheres®(resin) Y90 microspheres for the treatment of hepatocellular carcinoma. A systematic review was conducted using the databases MEDLINE, Embase, and Cochrane Trials Register to identify all relevant studies. Baseline characteristics and adverse events of all grades related to gastrointestinal, hepatobiliary, and respiratory systems were collected along with commonly reported outcomes related to post-embolization syndrome. For all outcomes, data from each study were tabulated for each intervention. Adverse events and patients were summed across studies on TheraSphere®and SIR-Spheres®, respectively, and the resulting proportion of patients experiencing an outcome for both interventions was calculated. Thirty-one observational studies were included in the review. In the adverse events of all grades, more patients treated with resin microspheres reported gastric ulcers, hepatic encephalopathy, cholecystitis, hepatic failure, and pleural effusion. Patients treated with resin microspheres also had more hepatobiliary adverse events of grade 3 or higher. In the events related to post-embolization syndrome, glass microspheres exhibited a similar safety profile compared to resin microspheres. Ascites and nausea grade 3 or higher were recorded more frequently with glass microsphere treatment. Based on this review of the published literature, glass microspheres exhibit a safety profile with fewer gastrointestinal and pulmonary adverse events compared to resin microspheres in the treatment of hepatocellular carcinoma.
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 N. St. Clair, Suite 800, Chicago, IL, 60611, USA.
authors.forename: Joseph Ralph
authors.initials: JR
authors.lastname: Kallini
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 N. St. Clair, Suite 800, Chicago, IL, 60611, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Gabr
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Redwood Outcomes Inc, Vancouver, BC, Canada.
authors.forename: Kristian
authors.initials: K
authors.lastname: Thorlund
authors.affiliation: Redwood Outcomes Inc, Vancouver, BC, Canada.|Department of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.
authors.forename: Chakrapani
authors.initials: C
authors.lastname: Balijepalli
authors.affiliation: Redwood Outcomes Inc, Vancouver, BC, Canada.
authors.forename: Dieter
authors.initials: D
authors.lastname: Ayres
authors.affiliation: Redwood Outcomes Inc, Vancouver, BC, Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Kanters
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Redwood Outcomes Inc, Vancouver, BC, Canada.
authors.forename: Shanil
authors.initials: S
authors.lastname: Ebrahim
authors.affiliation: Redwood Outcomes Inc, Vancouver, BC, Canada.|Stanford Prevention Research Center, Stanford School of Medicine, Stanford University, Stanford, CA, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Mills
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 N. St. Clair, Suite 800, Chicago, IL, 60611, USA.|Division of Hematology and Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Lewandowski
authors.affiliation: Section of Interventional Radiology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 676 N. St. Clair, Suite 800, Chicago, IL, 60611, USA. r-salem@northwestern.edu.|Division of Hematology and Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA. r-salem@northwestern.edu.
authors.forename: Riad
authors.initials: R
authors.lastname: Salem
mesh_terms: D000328:Adult; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008297:Male; D008863:Microspheres; D015021:Yttrium Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D015021:Yttrium Radioisotopes; C000615496:Yttrium-90
keywords: Adverse event; HCC; Hepatocellular carcinoma; SIR-Spheres; Safety; TheraSphere; Y90; Yttrium-90