Yttrium-90 Radioembolization in Patients with Hepatocellular Carcinoma Who have Previously Received Sorafenib

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dc.contributor.authorRana, Nitesh
dc.contributor.authorJu, Andrew Wenhua
dc.contributor.authorBazylewicz, Michael
dc.contributor.authorKallakury, Bhaskar
dc.contributor.authorHe, Aiwu Ruth
dc.contributor.authorUnger, Keith R.
dc.contributor.authorLee, Justin S.
dc.date.accessioned2016-06-23T16:46:47Z
dc.date.available2016-06-23T16:46:47Z
dc.date.issued2013-11
dc.description.abstractPurpose: Yttrium-90 radioembolization (RE) is a locoregional therapy option for hepatocellular carcinoma (HCC). Sorafenib is a multikinase inhibitor used in HCC that can potentially affect the efficacy of RE by altering tumor vascularity or suppressing post-irradiation angiogenesis. The safety and efficacy of sorafenib followed by RE has not been previously reported. Materials and Methods: Patients with HCC who received RE after sorafenib were included in this retrospective review. Overall survival, toxicity, and maximal radiographic response and necrosis criteria were examined. Results: Ten patients (15 RE administrations) fit the inclusion criteria. All were Barcelona Clinic Liver Cancer (BCLC) stage C. Median follow-up was 16.5 weeks. Median overall survival and radiographic progression-free survival were 30 and 28 weeks, respectively. Significant differences in overall survival were seen based on Child-Pugh class (p = 0.002) and radiographic response (p = 0.009). Three patients had partial response, six had stable disease, and one had progressive disease. Grade 1 or 2 acute fatigue, anorexia, and abdominal pain were common. Three patients had Grade 3 ascites in the setting of disease progression. Two patients had Grade 3 biochemical toxicity. One patient was sufficiently downstaged following RE and sorafenib to receive a partial hepatectomy. Conclusion: Yttrium-90 RE in patients with HCC who have received sorafenib demonstrate acceptable toxicity and rates of radiographic response. However, the overall survival is lower than that reported in the literature on RE alone or sorafenib alone. This may be due in part to more patients in this study having advanced disease compared to these other study populations. Larger prospective studies are needed to determine whether the combination of RE and sorafenib is superior to either therapy alone.en_US
dc.identifier.citationFrontiers in Oncology; 3: p. 1-10en_US
dc.identifier.doi10.3389/fonc.2013.00323
dc.identifier.issn2234-943X
dc.identifier.pmidpmc3874555en_US
dc.identifier.urihttp://hdl.handle.net/10342/5727
dc.relation.urihttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3874555/en_US
dc.subjectyttrium-90en_US
dc.subjectradioembolizationen_US
dc.subjectY90en_US
dc.subjectHCCen_US
dc.subjecthepatocellular carcinomaen_US
dc.subjectsorafeniben_US
dc.subjectSIRTen_US
dc.titleYttrium-90 Radioembolization in Patients with Hepatocellular Carcinoma Who have Previously Received Sorafeniben_US
dc.typeArticleen_US
ecu.journal.nameFrontiers in Oncologyen_US
ecu.journal.pages1-10en_US
ecu.journal.volume3en_US

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