Radioembolization improves chance of survival for liver cancer patients
Analysis revealed survival for patients with hepatocellular carcinoma (HCC) is achievable using 90Y-resin microsphere radioembolization. The analysis conducted at multiple centers across Europe showed that the procedure is likely to provide survival benefit across different tumor stages, including patients with advanced liver cancer and with limited treatment options. Findings of the studythe largest to dateare published in the September issue of Hepatology, a journal of the American Association for the Study of Liver Diseases.
According to the World Health Organization (WHO), nearly 700,000 deaths worldwide were attributed to HCC in 2008, with over 80% of these cases resulting from hepatitis B and C infections. Studies have shown an increased incidence of liver cancer including in developed countries, such as the U.S., and the disease is also affecting younger individuals. This year alone, the National Cancer Institute estimates there were more than 26,000 new cases of liver and bile duct cancer in the U.S., with close to 20,000 deaths attributed to the diseases.
"Hepatologists make decisions on treatment based upon the patient's underlying disease as well as tumor stage, taking into account whether tumor progression or advanced cirrhosis is more life-threatening," explains Bruno Sangro, MD, PhD, at the Clinica Universitaria de Navarra in Pamplona, Spain. "Patients with the disease confined to the liver, but who are not eligible for resection or transplantation need liver-directed therapies that reduce tumor burden, relieve symptoms and increase survival."
The current study evaluated the survival benefit of the liver-directed therapy, radioembolization, in 325 patients with HCC at eight European centers. Most patients received a single administration of microspheres with roughly 6% having two and 0.9% having three treatments between September 2003 and December 2009. The median activity of administered treatment was 1.6 GBq with approximately 45% of patients having whole liver and 39% having right-lobe infusions.
Of the HCC patients included in the analysis, 83% were Child-Pugh class A, 79% had underlying cirrhosis, and 88% had a good Eastern Oncology Group (ECOG) performance status. To measure the extent of HCC and liver function, researchers used the Barcelona Clinic Liver Cancer (BCLC) staging system; more than half of the patients were classified as advanced (BCLC C) and a quarter were intermediate (BCLC B) stage.
Results of the analysis showed that median overall survival with radioembolization was close to 13 months. Survival rates ranged depending upon BCLC class with those having less progressed disease and liver involvement (BCLC A) surviving 24 months, BCLC B at close to 17 months and BCLC C patients at 10 months. Researchers noted that the most significant factors affecting prognosis were ECOG performance status, tumor burden, coagulation test score (INR greater than 1.2), and disease outside the liver.
The team reported that the most common adverse events with radioembolization were fatigue, nausea, vomiting, and abdominal pain. Rates for all-cause mortality in this high-risk patient group were 0.6% and roughly 7% at 30 and 90 days, respectively. "Our findings show strong evidence of the survival benefit with radioembolization, even in patients with advanced disease who have few treatments options," concluded Dr. Sangro. "Further study of the procedure in patients with advanced disease is warranted."
More information: "Survival After Yttrium-90 Resin Microsphere Radioembolization of Hepatocellular Carcinoma Across Barcelona Clinic Liver Cancer Stages: A European Evaluation." Bruno Sangro, Livio Carpanese, Roberto Cianni, Rita Golfieri, Daniele Gasparini, Samer Ezziddin, Philipp M Paprottka, Francesco Fiore, Mark Van Buskirk, Jose Ignacio Bilbao, Giuseppe Maria Ettorre, Rita Salvatori, Emanuela Giampalma, Onelio Geatti, Kai Wilhelm, Ralf Thorsten Hoffmann, Francesco Izzo, Mercedes Iñarrairaegui, Carlo Ludovico Maini, Carlo Urigo, Alberta Cappelli, Alessandro Vit, Hojjat Ahmadzadehfar, Tobias Franz Jakobs, and Secondo Lastoria. Hepatology; Published Online: June 30, 2011 (DOI: 10.1002/hep.24451); Print Issue Date: September 2011.
Provided by Wiley
- Diabetes doubles liver cancer risk for patients with advanced hepatitis C May 29, 2008 | not rated yet | 0
- Liver cancer in cirrhotic patients effectively treated with radiofrequency ablation Dec 16, 2010 | not rated yet | 0
- Personalized treatment may help some liver cancer patients Oct 22, 2010 | not rated yet | 0
- New transplantation criteria for liver cancer patients Jul 28, 2010 | not rated yet | 0
- Combination therapy improves survival time for patients with advanced liver cancer Nov 16, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
In recent years, microRNAs (miRNAs) and other non-coding RNAs are small molecules that help control the expression of specific proteins. In recent years they have emerged as disease biomarkers. miRNA profiles have been used ...
Cancer 4 hours ago | not rated yet | 0
Cancer cells spread and grow by avoiding detection and destruction by the immune system. Stimulation of the immune system can help to eliminate cancer cells; however, there are many factors that cause the immune system to ...
Cancer 4 hours ago | not rated yet | 0
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
Cancer 7 hours ago | 5 / 5 (1) | 0
Transformative research from Western University has identified new hormones in the body which may suppress breast cancer and stimulate the regression of breast tumors.
Cancer 8 hours ago | 5 / 5 (1) | 0
(Medical Xpress)—Curtin University researchers have found evidence that targeting specific cells in the body can reverse the effects of cancer on the immune system.
Cancer 8 hours ago | 5 / 5 (3) | 0
(Medical Xpress)—A new study by researchers in the US has shown that an ancient virus can be modified to help in the fight against the simian immunodeficiency virus SIV, which is the equivalent in monkeys ...
7 hours ago | 5 / 5 (3) | 0 |
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
2 hours ago | 5 / 5 (1) | 0 |
Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences, according to a study from UCL.
4 hours ago | 5 / 5 (1) | 0 |
Biological processes are generally based on events at the molecular and cellular level. To understand what happens in the course of infections, diseases or normal bodily functions, scientists would need to ...
5 hours ago | 5 / 5 (2) | 0 |
Talking on a hands-free device while behind the wheel can lead to a sharp increase in errors that could imperil other drivers on the road, according to new research from the University of Alberta.
1 hour ago | not rated yet | 0
(Medical Xpress)—Regulating the distribution of power in neurons is done by a system that makes the national electric grid look simple by comparison. Each neuron has several thousand mitochondria confined ...
23 hours ago | 4.9 / 5 (9) | 0 |