未经证实:使用钇-90树脂微球的经动脉放射栓塞(TARE)是肝细胞癌(HCC)患者的既定治疗选择。然而,优化治疗应用和患者选择仍然具有挑战性。我们在这里报告有效性,安全性和预后因素,包括给药方法,在前瞻性观察性CIRT研究中与TARE治疗HCC相关。
UNASSIGNED:我们分析了在2015年1月至2017年12月之间招募的422例HCC患者,在首次TARE后每3个月进行随访,直至24个月。基线时收集患者特征和治疗相关数据;不良事件和事件发生时间数据(总生存期[OS],每3个月随访一次,收集无进展生存期[PFS]和肝脏PFS).我们使用多变量Cox比例风险模型和倾向评分匹配来确定有效性结果的独立预后因素。
未经评估:中位OS为16.5个月,中位PFS为6.1个月,中位肝PFS为6.7个月。与多变量分析的体表面积计算相比,分区模型剂量测定法提高了OS(危险比0.65;95%CI0.46-0.92;p=0.0144),这在完全匹配的倾向评分分析中得到了证实(风险比0.56;95%CI0.35-0.89;p=0.0136).OS的其他独立预后因素是ECOG表现状态>0(p=0.0018),腹水的存在(p=0.0152),右侧肿瘤(p=0.0002),门静脉血栓形成(p=0.0378)和主要门静脉血栓形成(p=0.0028)的存在,ALBI等级2(p=0.0043)和3(p=0.0014)。36.7%的患者发生不良事件,9.7%的患者经历3级或更高的不良事件。
UNASSIGNED:这个大型前瞻性观察数据集表明TARE是HCC患者的有效且安全的治疗方法。使用分区模型剂量测定与生存结果的显着改善相关。
UNASSIGNED:经动脉放射栓塞(TARE)是一种局部放射治疗,是原发性肝癌的潜在治疗选择。我们观察了TARE在各个欧洲国家的实际临床实践中的使用情况,以及是否有任何因素可以预测治疗效果。我们发现,当使用更复杂但个性化的方法来计算施加的辐射活动时,与使用更通用的方法相比,患者的反应更好.此外,我们确定了一般患者的健康状况,腹水和肝功能可以预测TARE后的预后。
未经评估:NCT02305459。
UNASSIGNED: Transarterial radioembolization (TARE) with Yttrium-90 resin microspheres is an established treatment option for patients with hepatocellular carcinoma (HCC). However, optimising treatment application and patient selection remains challenging. We report here on the effectiveness, safety and prognostic factors, including dosing methods, associated with TARE for HCC in the prospective observational CIRT study.
UNASSIGNED: We analysed 422 patients with HCC enrolled between Jan 2015 and Dec 2017, with follow-up visits every 3 months for up to 24 months after first TARE. Patient characteristics and treatment-related data were collected at baseline; adverse events and time-to-event data (overall survival [OS], progression-free survival [PFS] and hepatic PFS) were collected at every 3-month follow-up visit. We used the multivariable Cox proportional hazard model and propensity score matching to identify independent prognostic factors for effectiveness outcomes.
UNASSIGNED: The median OS was 16.5 months, the median PFS was 6.1 months, and the median hepatic PFS was 6.7 months. Partition model dosimetry resulted in improved OS compared to body surface area calculations on multivariable analysis (hazard ratio 0.65; 95% CI 0.46-0.92; p = 0.0144), which was confirmed in the exact matching propensity score analysis (hazard ratio 0.56; 95% CI 0.35-0.89; p = 0.0136). Other independent prognostic factors for OS were ECOG-performance status >0 (p = 0.0018), presence of ascites (p = 0.0152), right-sided tumours (p = 0.0002), the presence of portal vein thrombosis (p = 0.0378) and main portal vein thrombosis (p = 0.0028), ALBI grade 2 (p = 0.0043) and 3 (p = 0.0014). Adverse events were recorded in 36.7% of patients, with 9.7% of patients experiencing grade 3 or higher adverse events.
UNASSIGNED: This large prospective observational dataset shows that TARE is an effective and safe treatment in patients with HCC. Using partition model dosimetry was associated with a significant improvement in survival outcomes.
UNASSIGNED: Transarterial radioembolization (TARE) is a form of localised radiation therapy and is a potential treatment option for primary liver cancer. We observed how TARE was used in real-life clinical practice in various European countries and if any factors predict how well the treatment performs. We found that when a more complex but personalised method to calculate the applied radiation activity was used, the patient responded better than when a more generic method was used. Furthermore, we identified that general patient health, ascites and liver function can predict outcomes after TARE.
UNASSIGNED: NCT02305459.