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. 2021 Dec 7:8:1565-1577.
doi: 10.2147/JHC.S335879. eCollection 2021.

Yttrium-90 Radioembolization Is Associated with Better Clinical Outcomes in Patients with Hepatocellular Carcinoma Compared with Conventional Chemoembolization: A Propensity Score-Matched Study

Minseok Albert Kim  1 , Heejoon Jang  1 , Na Ryung Choi  1 , Joon Yeul Nam  1 , Yun Bin Lee  1 , Eun Ju Cho  1 , Jeong-Hoon Lee  1 , Su Jong Yu  1 , Hyo-Cheol Kim  2 , Jin Wook Chung  2 , Jung-Hwan Yoon  1 , Yoon Jun Kim  1
Affiliations

Yttrium-90 Radioembolization Is Associated with Better Clinical Outcomes in Patients with Hepatocellular Carcinoma Compared with Conventional Chemoembolization: A Propensity Score-Matched Study

Minseok Albert Kim et al. J Hepatocell Carcinoma. .

Abstract

Background: Both trans-arterial radioembolization (TARE) and conventional trans-arterial chemoembolization (TACE) can effectively control hepatocellular carcinoma (HCC) in patients who are not suitable for curative resection. This study compared the effectiveness of TARE and conventional TACE as the initial trans-arterial treatment for hepatocellular carcinoma (HCC) assessed by tumor response and clinical outcomes.

Material and methods: Data were retrospectively analyzed the propensity score-matched cohort for overall survival (OS), progression-free survival (PFS), and intrahepatic PFS in patients who have received TARE or TACE as the first HCC treatment from March 2012 to December 2017.

Results: A total of 138 patients initially treated with TARE (n = 54) or TACE (n = 84) was included in this study. Of 138 patients, median age was 59 years and the mean follow-up period was 27.6 months. TARE showed better OS (hazard ratio [HR] = 0.54, 95% confidence interval [CI] = 0.31-0.92, log-rank P = 0.02), better PFS (HR = 0.51, 95% CI = 0.36-0.97, log-rank P = 0.04), and better intrahepatic PFS (HR = 0.51, 95% CI = 0.30-0.88, log-rank P = 0.01) compared with TACE. TARE was an independent prognostic factor for OS (adjusted HR [aHR] = 0.52, 95% CI = 0.30-0.90, P = 0.02), PFS (aHR = 0.57, 95% CI = 0.35-0.94, P = 0.03), and intrahepatic PFS (aHR = 0.49, 95% CI = 0.28-0.84, P = 0.01).

Conclusion: TARE as initial trans-arterial treatment is associated with better clinical outcomes such as longer OS compared with TACE in patients with HCC.

Keywords: brachytherapy; embolization; liver neoplasms; yttrium radioisotopes.

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Conflict of interest statement

All authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
CONSORT flow diagram of the study.
Figure 2
Figure 2
Comparisons of OS between patients initially treated with TARE and TACE in (A) the entire study population (n = 138), (B) patients without lymph node and distant metastases (n = 123), (C) patients whose BCLC stage at diagnosis was stage B or C (n = 103), and (D) patients with tumor diameter ≥5 cm before the first treatment (n = 110).
Figure 3
Figure 3
Comparisons of PFS between patients initially treated with TARE and TACE in (A) the entire study population (n = 138), (B) patients without lymph node and distant metastases (n = 123), (C) patients whose BCLC stage at diagnosis was stage B or C (n = 103), and (D) patients with tumor diameter ≥ 5 cm before the first treatment (n = 110).
Figure 4
Figure 4
Comparisons of intrahepatic PFS between patients initially treated with TARE and TACE in (A) the entire study population (n = 138), (B) patients without lymph node and distant metastases (n = 123), (C) patients whose BCLC stage at diagnosis was stage B or C (n = 103), and (D) patients with tumor diameter ≥5 cm before the first treatment (n = 110).
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