The December 2005 issue of the Journal of Vascular and Interventional Radiology presented the following TheraSphere article for treatment of a broad spectrum of patients presenting with unresectable HCC. 43 patients were segmented into three risk groups according to method of treatment and risk stratification: Group 0, segmental; Group 1, lobar low risk; and Group 2, lobar high risk. Highlighted results include:
- 47% of all patients had an objective tumor response based on % reduction in tumor size
- 79% had tumor response when % reduction and/or tumor necrosis were used as composite measure of tumor response
- Median survival times were 46.5 months, 16.9 months, and 11.1 months for groups 0, 1, and 2 respectively
We encourage you to read the following abstract in its entirety. You can also access this, and other abstracts, on the TheraSphere website at http://www.mds.nordion.com/therasphere/physicians/publications.asp.
Treatment of Unresectable Hepatocellular Carcinoma with Use of 90Y Microspheres (TheraSphere): Safety, Tumor Response, and Survival
Riad Salem, MD, MBA, Robert J. Lewandowski, MD, Bassel Atassi, MD, Stuart C. Gordon, MD, Vanessa L. Gates, MS, Omar Barakat, Ziad Sergie, Ching-Yee O. Wong, MD, PhD, and Kenneth G. Thurston, MA
PURPOSE: To present safety and efficacy results obtained in treatment of a cohort of patients with unresectable hepatocellular carcinoma (HCC) with use of 90Y microspheres (TheraSphere).
PATIENTS AND METHODS: Forty-three consecutive patients with HCC were treated with 90Y microspheres over a 4-year period. Patients were treated by liver segment or lobe on one or more occasions based on tumor distribution, liver function, and vascular flow dynamics. Patients were followed for adverse events, objective tumor response, and survival. Patients were stratified into three risk groups according to method of treatment and risk stratification (group 0, segmental; group 1, lobar low-risk; group 2, lobar high-risk) and Okuda and Child-Pugh scoring systems.
RESULTS: Based on follow-up data from 43 treated patients, 20 patients (47%) had an objective tumor response based on percent reduction in tumor size and 34 patients (79%) had a tumor response when percent reduction and/or tumor necrosis were used as a composite measure of tumor response. There was no statistical difference among the three risk groups with respect to tumor response. Survival times from date of diagnosis were different among the risk groups (P < .0001). Median survival times were 46.5 months, 16.9 months, and 11.1 months for groups 0, 1, and 2, respectively. Median survival times of 24.4 months and 12.5 months by Okuda scores of I and II, respectively, were achieved (mean, 25.8 months vs 13.1). Patients had median survival times of 20.5 months and 13.8 months according to Child class A and class B/C disease, respectively (mean, 22.7 months vs 13.6 months). Patients classified as having diffuse disease exhibited decreased survival and reduced tumor response. There were no life-threatening adverse events related to treatment.
CONCLUSIONS: Use of 90Y microspheres (TheraSpheres) provides a safe and effective method of treatment for a broad spectrum of patients presenting with unresectable HCC. Further investigation is warranted.
J Vasc Interv Radiol 2005; 16:1627–1639
Abbreviations: ECOG _ Eastern Cooperative Oncology Group, HCC _ hepatocellular carcinoma, TACE _ transcatheter arterial chemoembolization
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