Objective Tumor Response of Hepatocellular Carcinoma Obtained by Transarterial Radioembolization with Iodine-131-Lipiodol Versus Transarterial Chemoembolization for Patients with and without Portal Venous Thrombosis: A Controlled Interventional Trial.

Autor:	Oliveira Ribeiro MC; Department of Internal Medicine, Sao Paulo State University (UNESP), Brazil (M.C.O.R., K.A.M., C.C., F.G.R.)., Moda KA; Department of Internal Medicine, Sao Paulo State University (UNESP), Brazil (M.C.O.R., K.A.M., C.C., F.G.R.)., Alvarez M; Center of Medical Physics and Radiation Protection, Clinical Hospital at Botucatu School of Medicine-HC-FMB, Botucatu, Brazil (M.A.)., Koga KH; Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Sao Paulo State University (UNESP), Brazil (K.H.K., S.M.M.)., Moriguchi SM; Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Sao Paulo State University (UNESP), Brazil (K.H.K., S.M.M.)., Carvalho FC; Department of Internal Medicine, Sao Paulo State University (UNESP), Brazil (M.C.O.R., K.A.M., C.C., F.G.R.)., Pinheiro RSN; Liver and Digestive Organs Transplantation Division, Gastroenterology Department, Clinical Hospital of Sao Paulo University - HCFMUSP, Brazil (R.S.N.P.)., Qi X; Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), Shenyang, China (X.Q.)., Romeiro FG; Department of Internal Medicine, Sao Paulo State University (UNESP), Brazil (M.C.O.R., K.A.M., C.C., F.G.R.). Electronic address: fernando.romeiro@unesp.br.
Jazyk:	angličtina
Zdroj:	Academic radiology [Acad Radiol] 2024 May; Vol. 31 (5), pp. 1839-1848. Date of Electronic Publication: 2023 Nov 27.
DOI:	10.1016/j.acra.2023.10.029
Abstrakt:	Rationale and Objectives: Hepatocellular carcinoma (HCC) treatment often requires transarterial chemoembolization (TACE). However, TACE efficacy is controversial in the presence of portal vein thrombosis (PVT). Although transarterial radioembolization (TARE) benefit was previously documented in PVT, neither the objective tumor response (OTR) after TARE with Iodine-131-lipiodol ( 131 I-lipiodol) nor the PVT effect on the results of locoregional therapies was accurately measured in prospective clinical trials. The aim of this study was to compare OTR and survival obtained by TARE with 131 I-lipiodol versus TACE in patients with cirrhosis and HCC, as well as between those with and without PVT. Materials and Methods: 33 patients were included, from whom 38 tumors were assessed. OTR was quantified by a special algorithm to measure hypervascular HCC tissue. Results: 19 tumors received each therapy. Nine subjects (27%) had PVT, most of them in the TARE group (p = 0.026). Mean OTR according to the tumor volumes was 24.2% ± 56% after TARE and 32.8% ± 48.9% after TACE, with no difference between the treatments (p = 0.616). Similar values were also observed between those with and without PVT (p = 0.704). Mean survival was 340 days and did not differ between the two treatments (p = 0.596), but was 194 days in PVT cases (p = 0.007). Conclusions: This is the first study in which OTR obtained by TARE with 131 I-lipiodol is accurately measured. Additionally, PVT impact on survival after TARE and TACE was precisely documented. Although the TARE group had more PVT subjects (who had shorter survival), TARE and TACE achieved similar OTR and OS rates. Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Fernando Gomes Romeiro reports financial support was provided by São Paulo Research Foundation (FAPESP). Fernando Gomes Romeiro reports financial support was provided by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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