Yttrium-90 microspheres (TheraSphere®) treatment of unresectable hepatocellular carcinoma:: Downstaging to resection, RFA and bridge to transplantation
Yttrium-90 microspheres (TheraSphere®) treatment of unresectable hepatocellular carcinoma:: Downstaging to resection, RFA and bridge to transplantation
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DOI：
10.1002/jso.20609
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发表时间：
2006-12-01
影响因子：
2.5
通讯作者：
Salem, Riad
中科院分区：
文献类型：
--
作者：
Kulik, Laura M.;Atassi, Bassel;Salem, Riad
目的：目的：分析35例T3期不能切除的肝癌（HCC）患者应用Y-90微球治疗的临床资料。方法：对150例不能切除的HCC患者应用Y-90微球治疗。其中，35例患者在治疗时为UNOS T3期。患者的临床毒性，改变终末期肝病（MELD）评分模型，肿瘤反应，降级到RFA，切除，移植，和survival.Results：19 34例（56%）成功降级T3 T2治疗后。11/34例（32%）患者的靶病灶直径小于或等于3.0 cm，23/35例（66%）患者的靶病灶直径小于或等于3.0 cm（RFA候选者）或肿瘤切除术。根据WHO标准，34例患者中有17例（50%）有客观肿瘤缓解。8例患者（23%）成功降级并在治疗后接受了奥尔特。1、2和3年生存率分别为84%、54%和27%。Kaplan-Meier分析的中位生存率为800 days.Conclusion：这些数据表明，动脉内Y-90微球可用作移植、手术切除或RFA的桥梁。
Purpose: To present the clinical data of 35 patients with T3 unresectable hepatocellular carcinoma (HCC) that were treated with Y-90 with the specific intent of downstaging to resection, radiofrequency ablation (RFA) candidate, United Network for Organ Sharing (UNOS) stage T2 or liver transplantation.Materials and Methods: One hundred fifty patients with unresectable HCC were treated with Y-90 microspheres. Of these, 35 patients were UNOS stage T3 at the time of treatment. Patients were followed for clinical toxicities, alterations in model for end-stage-liver disease (MELD) score, tumor response, downstaging to RFA, resection, transplantation, and survival.Results: Nineteen of 34 patients (56%) were successfully downstaged from T3 to T2 following treatment. 11 of 34 (32%) patients treated were downstaged to target lesions measuring 3.0 cm or less. Twenty-three of 35 (66%) were downstaged to either T2 status, lesion < 3.0 cm (RFA candidate), or resection. Seventeen of 34 (50%) had an objective tumor response by WHO criteria. Eight patients (23%) were successfully downstaged and underwent OLT following treatment. 1, 2, and 3-year survival was 84%, 54%, and 27%, respectively. Median survival by Kaplan-Meier analysis for the entire cohort was 800 days.Conclusion: These data suggest that intra-arterial Y-90 microspheres can be used as a bridge to transplantation, surgical resection, or RFA.