TY - JOUR
T1 - Liver decompensation as late complication in hcc patients with long-term response following selective internal radiation therapy
AU - van Doorn, Diederick J.
AU - Hendriks, Pim
AU - Burgmans, Mark C.
AU - Rietbergen, Daphne D. D.
AU - Coenraad, Minneke J.
AU - van Delden, Otto M.
AU - Bennink, Roel J.
AU - Labeur, Tim A.
AU - Klümpen, Heinz-Josef
AU - Eskens, Ferry A. L. M.
AU - Moelker, Adriaan
AU - Vegt, Erik
AU - Sprengers, Dave
AU - Mostafavi, Nahid
AU - Ijzermans, Jan
AU - Takkenberg, R. Bart
N1 - Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Selective internal radiation therapy (SIRT) is used as a treatment for hepatocellular carcinoma (HCC). The aim of this study was to assess long-term liver-related complications of SIRT in patients who had not developed radioembolization-induced liver disease (REILD). The primary outcome was the percentage of patients without REILD that developed Child-Pugh (CP) ≥ B7 liver decompensation after SIRT. The secondary outcomes were overall survival (OS) and tumor response. These data were compared with a matched cohort of patients treated with sorafenib. Eighty-five patients were included, of whom 16 developed REILD. Of the remaining 69 patients, 38 developed liver decompensation CP ≥ B7. The median OS was 18 months. In patients without REILD, the median OS in patients with CP ≥ B7 was significantly shorter compared to those without CP ≥ B7; 16 vs. 31 months. In the case-matched analysis, the median OS was significantly longer in SIRT-treated patients; 16 vs. 8 months in sorafenib. Liver decompensation CP ≥ B7 occurred significantly more in SIRT when compared to sorafenib; 62% vs. 27%. The ALBI score was an independent predictor of liver decompensation (OR 0.07) and OS (HR 2.83). After SIRT, liver decompensation CP ≥ B7 often developed as a late complication in HCC patients and was associated with a shorter OS. The ALBI score was predictive of CP ≥ B7 liver decompensation and the OS, and this may be a valuable marker for patient selection for SIRT.
AB - Selective internal radiation therapy (SIRT) is used as a treatment for hepatocellular carcinoma (HCC). The aim of this study was to assess long-term liver-related complications of SIRT in patients who had not developed radioembolization-induced liver disease (REILD). The primary outcome was the percentage of patients without REILD that developed Child-Pugh (CP) ≥ B7 liver decompensation after SIRT. The secondary outcomes were overall survival (OS) and tumor response. These data were compared with a matched cohort of patients treated with sorafenib. Eighty-five patients were included, of whom 16 developed REILD. Of the remaining 69 patients, 38 developed liver decompensation CP ≥ B7. The median OS was 18 months. In patients without REILD, the median OS in patients with CP ≥ B7 was significantly shorter compared to those without CP ≥ B7; 16 vs. 31 months. In the case-matched analysis, the median OS was significantly longer in SIRT-treated patients; 16 vs. 8 months in sorafenib. Liver decompensation CP ≥ B7 occurred significantly more in SIRT when compared to sorafenib; 62% vs. 27%. The ALBI score was an independent predictor of liver decompensation (OR 0.07) and OS (HR 2.83). After SIRT, liver decompensation CP ≥ B7 often developed as a late complication in HCC patients and was associated with a shorter OS. The ALBI score was predictive of CP ≥ B7 liver decompensation and the OS, and this may be a valuable marker for patient selection for SIRT.
KW - Hepatocellular carcinoma
KW - Liver decompensation
KW - Long-term response
KW - Overall survival
KW - Selective internal radiation therapy
UR - http://www.scopus.com/inward/record.url?scp=85117934185&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/cancers13215427
DO - https://doi.org/10.3390/cancers13215427
M3 - Article
C2 - 34771591
SN - 2072-6694
VL - 13
JO - Cancers
JF - Cancers
IS - 21
M1 - 5427
ER -