Is radioembolization (90Y) better than doxorubicin drug eluting beads (DEBDOX) for hepatocellular carcinoma with portal vein thrombosis? A retrospective analysis. (September 2015)

• Record Type: Journal Article
• Authors: Akinwande, Olaguoke; Kim, Daniel; Edwards, Jacob; Brown, Russell; Philips, Prejesh; Scoggins, Charles; Martin, Robert C.G.
• Is Part Of: Surgical oncology. Volume 24:Number 3(2015)
• Page Start: 270
• Page End: 275
• Publication Date: 2015-09
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Electronic journals; 616.994059
• DOI: 10.1016/j.suronc.2015.06.008
• Languages: English
• ISSNs: 0960-7404

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Abstract</title> <sec> <title id="sectitle0015">Introduction</title> <p id="abspara0010">This study compares radioembolization (<sup>90</sup>Y) versus doxorubicin drug eluting beads (DEBDOX) in the treatment of unresectable hepatocellular carcinoma with portal vein thrombosis.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">Using our prospectively maintained, multi-center, non-controlled intra-arterial therapy registry, we identified 28 consecutive patients with hepatocellular carcinoma (HCC) and portal vein thrombosis (PVT) treated with DEBDOX and 20 with <sup>90</sup>Y. Follow-up protocol consisted of a 3-phase CT scan of the liver within 3 months post-treatment. Tumor response rates were measured according to modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">There were 65 and 29 treatments in the DEBDOX and <sup>90</sup>Y groups respectively. Median age of DEBDOX was 59.8 (35–81) and <sup>90</sup>Y was 66.5 (49–82) years. A defined number of lesions were seen in 78% DEBDOX and 50% <sup>90</sup>Y patients. Patients were similar in the remaining 8 baseline characteristics including performance status, Child Pugh and extent of PVT. There were fewer overall side effects in the DEBDOX group compared to the <sup>90</sup>Y group (11% vs 39%; P = 0.03). There was better disease control (mRECIST) in the DEBDOX group compared to the <sup>90</sup>Y group (67% vs 20%; P = 0.0014). Median survival times were 10 months in DEBDOX and 3 months in the <sup>90</sup>Y group respectively from first treatment (log-rank, P = 0.037).</p> </sec> <sec> <title id="sectitle0030">Conclusion</title> <p id="abspara0025">DEBDOX is safe for patients with HCC and PVT and may have lower toxicity than <sup>90</sup>Y. It may also provide better disease control and survival benefit. Further studies are warranted to validate our observations and to determine if current clinical practice should be altered.</p> </sec> </abstract>