Randomized Comparison of Selective Internal Radiotherapy (SIRT) Versus Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE) for the Treatment of Hepatocellular Carcinoma

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• 作者：Michael B. Pitton ; Roman Kloeckner…
• 关键词：Selective internal radiotherapy (SIRT) ; Drug ; eluting bead ; transarterial chemoembolization (DEB ; TACE) ; Radiation induced liver disease (RILD) ; Liver cirrhosis
• 刊名：CardioVascular and Interventional Radiology
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：38
• 期：2
• 页码：352-360
• 全文大小：333 KB
• 参考文献：EASL–EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 56: pp. 908-943
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Nuclear Medicine
  Ultrasound
  Cardiology
  
• 出版者：Springer New York
• ISSN：1432-086X

文摘

Purpose To prospectively compare SIRT and DEB-TACE for treating hepatocellular carcinoma (HCC). Methods From 04/2010-7/2012, 24 patients with histologically proven unresectable N0, M0 HCCs were randomized 1:1 to receive SIRT or DEB-TACE. SIRT could be repeated once in case of recurrence; while, TACE was repeated every 6?weeks until no viable tumor tissue was detected by MRI or contraindications prohibited further treatment. Patients were followed-up by MRI every 3?months; the final evaluation was 05/2013. Results Both groups were comparable in demographics (SIRT: 8males/4females, mean age 72?±?7?years; TACE: 10males/2females, mean age 71?±?9?years), initial tumor load (1 patient ?5?% in each group), and BCLC (Barcelona Clinic Liver Cancer) stage (SIRT: 12×B; TACE 1×A, 11×B). Median progression-free survival (PFS) was 180?days for SIRT versus 216?days for TACE patients (p?=?0.6193) with a median TTP of 371?days versus 336?days, respectively (p?=?0.5764). Median OS was 592?days for SIRT versus 788?days for TACE patients (p?=?0.9271). Seven patients died in each group. Causes of death were liver failure (n?=?4 SIRT group), tumor progression (n?=?4 TACE group), cardiovascular events, and inconclusive (n?=?1 in each group). Conclusions No significant differences were found in median PFS, OS, and TTP. The lower rate of tumor progression in the SIRT group was nullified by a greater incidence of liver failure. This pilot study is the first prospective randomized trial comparing SIRT and TACE for treating HCC, and results can be used for sample size calculations of future studies.