Selective internal radiation therapy for unresectable HCC: The SIRT downstaging study.

Autor:	Regnault H; Hepatology Department, Henri Mondor Hospital (AP-HP), Créteil, France.; Team 'Viruses, Hepatology, Cancer', Institut Mondor de Recherche Biomédicale, INSERM U955, Hôpital Henri Mondor (AP-HP), Université Paris-Est, Créteil, France., Chalaye J; Nuclear Medicine Department, Henri Mondor Hospital (AP-HP), Créteil, France., Galetto-Pregliasco A; Radiology Department, Henri Mondor Hospital (AP-HP), Créteil, France., Perrin C; Hepatology Department, Henri Mondor Hospital (AP-HP), Créteil, France., Derbel H; Radiology Department, Henri Mondor Hospital (AP-HP), Créteil, France., Amaddeo G; Hepatology Department, Henri Mondor Hospital (AP-HP), Créteil, France.; Team 'Viruses, Hepatology, Cancer', Institut Mondor de Recherche Biomédicale, INSERM U955, Hôpital Henri Mondor (AP-HP), Université Paris-Est, Créteil, France., Mulé S; Team 'Viruses, Hepatology, Cancer', Institut Mondor de Recherche Biomédicale, INSERM U955, Hôpital Henri Mondor (AP-HP), Université Paris-Est, Créteil, France.; Radiology Department, Henri Mondor Hospital (AP-HP), Créteil, France., Lequoy M; Hepatology Department, Saint Antoine Hospital (AP-HP), Paris, France., Kobeiter H; Radiology Department, Henri Mondor Hospital (AP-HP), Créteil, France., Reizine E; Radiology Department, Henri Mondor Hospital (AP-HP), Créteil, France., Itti E; Nuclear Medicine Department, Henri Mondor Hospital (AP-HP), Créteil, France., Duvoux C; Hepatology Department, Henri Mondor Hospital (AP-HP), Créteil, France., Laurent A; Hepatobiliary Surgery, Henri Mondor Hospital (AP-HP), Créteil, France., Leroy V; Hepatology Department, Henri Mondor Hospital (AP-HP), Créteil, France.; Team 'Viruses, Hepatology, Cancer', Institut Mondor de Recherche Biomédicale, INSERM U955, Hôpital Henri Mondor (AP-HP), Université Paris-Est, Créteil, France., Sommacale D; Hepatobiliary Surgery, Henri Mondor Hospital (AP-HP), Créteil, France., Rasolonirina D; Nuclear Medicine Department, Henri Mondor Hospital (AP-HP), Créteil, France., Luciani A; Team 'Viruses, Hepatology, Cancer', Institut Mondor de Recherche Biomédicale, INSERM U955, Hôpital Henri Mondor (AP-HP), Université Paris-Est, Créteil, France.; Radiology Department, Henri Mondor Hospital (AP-HP), Créteil, France., Calderaro J; Team 'Viruses, Hepatology, Cancer', Institut Mondor de Recherche Biomédicale, INSERM U955, Hôpital Henri Mondor (AP-HP), Université Paris-Est, Créteil, France.; Department of Pathology, Henri Mondor Hospital (AP-HP), Créteil, France., Tacher V; Team 'Viruses, Hepatology, Cancer', Institut Mondor de Recherche Biomédicale, INSERM U955, Hôpital Henri Mondor (AP-HP), Université Paris-Est, Créteil, France.; Radiology Department, Henri Mondor Hospital (AP-HP), Créteil, France., Brustia R; Team 'Viruses, Hepatology, Cancer', Institut Mondor de Recherche Biomédicale, INSERM U955, Hôpital Henri Mondor (AP-HP), Université Paris-Est, Créteil, France.; Hepatobiliary Surgery, Henri Mondor Hospital (AP-HP), Créteil, France.
Jazyk:	angličtina
Zdroj:	Hepatology communications [Hepatol Commun] 2024 Jun 27; Vol. 8 (7). Date of Electronic Publication: 2024 Jun 27 (Print Publication: 2024).
DOI:	10.1097/HC9.0000000000000475
Abstrakt:	Background: Selective internal radiation therapy (SIRT) is recommended as a downstaging (DS) strategy for solitary unresectable HCC <8 cm. The aim of this study was to report the results of acquired experience in a tertiary center for all unresectable HCCs. Methods: We conducted a retrospective, observational study using data collected from consecutive patients undergoing SIRT between October 2013 and June 2020. DS was considered achieved when a curative treatment could be proposed 6 months after SIRT. Results: One hundred twenty-seven patients were included (male = 90%, 64 ± 11 y), of whom 112 (n = 88%) had cirrhosis. HCC was classified as BCLC stage C in 64 patients (50%), with a median diameter of 61 mm, an infiltrative pattern in 51 patients (40%), and portal vein invasion in 62 (49%) patients. Fifty patients (39%) achieved DS 6 months following SIRT, with 29 of them (23%) undergoing curative treatment in a median time of 4.3 months: 17 (13%) were transplanted, 11 (85%) had liver resection, and 1 patient had a radiofrequency ablation. The median overall survival of patients with or without DS was 51 versus 10 months, respectively (p < 0.001). In patients who achieved DS, progression-free survival was higher in patients who underwent surgery: 47 versus 11 months (p < 0.001). Four variables were independently associated with DS: age (OR: 0.96, 95% CI: [0.92, 0.99]; p = 0.032), baseline α-fetoprotein (OR: 1.00, 95% CI: [1.00, 1.00]; p = 0.034), HCC distribution (OR: 0.3, 95% CI: [0.11, 0.75]; p = 0.012), and ALBI grade (OR: 0.34. 95% CI: [0.14, 0.80]; p = 0.014). Conclusions: These results suggest that SIRT in patients with unresectable HCC could be an effective treatment: DS was achieved for around 39% of the patients and more than half of these then underwent curative treatment. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Study of Liver Diseases.)
Databáze:	MEDLINE
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