Outcomes of Transarterial Hepatic Embolization versus Yttrium-90 Radioembolization for Treatment of Patients with Hepatocellular Carcinoma >7 cm

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE Journal of Vascular and Interventional Radiology Pub Date : 2025-03-13 DOI:10.1016/j.jvir.2025.03.006

Sam Y. Son MD , Sara Velayati MD , Ken Zhao MD , Brett Marinelli MD , Ruben Geevarghese MBBS , Vlasios S. Sotirchos MD , Anne Covey MD , James J. Harding MD , Michael I. D’Angelica MD , William R. Jarnagin MD , Alice Wei MD , Hooman Yarmohammadi MD

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Abstract

Purpose

To assess and compare the safety, effectiveness, and outcomes of transarterial hepatic embolization (TAE) and transarterial radioembolization (TARE) for the treatment of patients with unresectable hepatocellular carcinoma (HCC) >7 cm.

Materials and Methods

Treatment-naive patients with HCC >7 cm who were treated with TAE or TARE between January 2013 and December 2023 were reviewed in this retrospective study. Nearest neighbor 2:1 propensity score matching was utilized for direct comparison. Radiological treatment response was assessed using the modified Response Evaluation Criteria in Solid Tumours (mRECIST). Kaplan-Meier survival curves were used to estimate progression-free survival (PFS) and overall survival (OS). Log-rank tests were performed to compare survival curves.

Results

A total of 125 patients with HCC >7 cm were treated with TAE (n = 103) or TARE (n = 22). After propensity score matching, 44 patients who underwent TAE and 22 patients who were treated with TARE were compared. The mean tumor sizes were 10.4 cm (SD ± 2.6) in the TAE group and 10.7 cm (SD ± 2.7) in the TARE group (P > .695). TAE and TARE exhibited comparable adverse event (AE) rates (Grade 1 AE in 22 [50%] of 44 in TAE and 6 [27%] of 22 in TARE, P = .999; 1 Grade 2 AE [4.5%] in TAE). Median OS durations were 15.2 and 23.6 months in the TAE and TARE groups, respectively (P = .252). Median local PFS (4.7 vs 21.6 months, P < .001) and PFS (3.6 vs 10.0 months, P = .002) were significantly longer after TARE. TAE and TARE had similar objective response rates (TAE, 88.6% vs TARE, 77.3%; P = .364). Systemic therapy after TAE or TARE was a significant positive prognostic factor associated with freedom from disease progression and survival (PFS hazard ratio [HR], 0.58 [P = .047]; OS HR, 0.33 [P < .001]).

Conclusions

TAE and TARE are both safe transarterial therapies for patients with HCC >7 cm. TARE is associated with a longer time to progression and longer OS.

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经动脉肝栓塞与钇-90放射栓塞治疗bb7cm肝细胞癌的疗效比较

目的：评价经动脉肝栓塞（TAE）和钇-90放射栓塞（TARE）治疗大（> - 7cm）肝细胞癌（HCC）的安全性和疗效。方法与材料：本研究回顾性分析了2013年1月至2023年12月期间接受TAE或TARE治疗的原发性肝癌bbb7cm患者。直接比较采用最近邻2:1倾向评分匹配。使用mRECIST评估放射治疗反应。Kaplan-Meier生存曲线用于估计无进展（PFS）和总生存（OS）。采用对数秩检验比较生存曲线。结果：125例肝细胞癌（肝细胞癌直径为70cm）患者接受TAE（103例）或TARE（22例）治疗。倾向评分匹配后，44名接受TAE治疗的患者和22名接受TARE治疗的患者进行比较。平均肿瘤大小分别为10.4±2.6cm （TAE）和10.7±2.7cm (TARE) （p < 0.05）。TAE和TARE表现出相当的不良事件发生率(1级AE: TAE为22/44 (50%)，TARE为6/22 (27%)；p = 0.999;AE 2级1名（4.5%）。TAE组和TARE组的中位OS分别为15.2和23.6个月（p=0.252）。中位局部无进展生存期(LPFS；结论：TAE和TARE均是肝细胞癌（HCC）患者经动脉治疗的安全方法。TARE与较长的进展时间和较长的OS相关。

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来源期刊

Journal of Vascular and Interventional Radiology 医学-核医学

CiteScore

4.30

自引率

10.30%

发文量

942

审稿时长

90 days

期刊介绍： JVIR, published continuously since 1990, is an international, monthly peer-reviewed interventional radiology journal. As the official journal of the Society of Interventional Radiology, JVIR is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of vascular and interventional radiology. Each issue of JVIR covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field.