CardioVascular and Interventional Radiology

, Volume 36, Issue 3, pp 714–723

Efficacy and Safety of Transarterial Radioembolization Versus Chemoembolization in Patients With Hepatocellular Carcinoma

  • Laura E. Moreno-Luna
  • Ju Dong Yang
  • William Sanchez
  • Ricardo Paz-Fumagalli
  • Denise M. Harnois
  • Teresa A. Mettler
  • Denise N. Gansen
  • Piet C. de Groen
  • Konstantinos N. Lazaridis
  • K. V. Narayanan Menon
  • Nicholas F. LaRusso
  • Steven R. Alberts
  • Gregory J. Gores
  • Chad J. Fleming
  • Seth W. Slettedahl
  • William S. Harmsen
  • Terry M. Therneau
  • Gregory A. Wiseman
  • James C. Andrews
  • Lewis R. Roberts
Clinical Investigation

DOI: 10.1007/s00270-012-0481-2

Cite this article as:
Moreno-Luna, L.E., Yang, J.D., Sanchez, W. et al. Cardiovasc Intervent Radiol (2013) 36: 714. doi:10.1007/s00270-012-0481-2

Abstract

Purpose

Intermediate-stage hepatocellular carcinoma (HCC) is usually treated with locoregional therapy using transarterial chemoembolization (TACE). Transarterial radioembolization (TARE) using β-emitting yttrium-90 integral to the glass matrix of the microspheres is an alternative to TACE. This retrospective case-control study compared the outcomes and safety of TARE versus TACE in patients with unresectable HCC.

Materials and Methods

Patients with unresectable HCC without portal vein thrombosis treated with TARE between 2005 and 2008 (n = 61) were retrospectively frequency-matched by age, sex, and liver dysfunction with TACE-treated patients (n = 55) in the Mayo Clinic Hepatobiliary Neoplasia Registry. Imaging studies were reviewed, and clinical and safety outcomes were abstracted from the medical records.

Results

Complete tumor response was more common after TARE (12 %) than after TACE (4 %) (p = 0.17). When complete response was combined with partial response and stable disease, there was no difference between TARE and TACE. Median survival did not differ between the two groups (15.0 months for TARE and 14.4 months for TACE; p = 0.47). Two-year survival rates were 30 % for TARE and 24 % for TACE. TARE patients received fewer treatments (p < 0.001). Fifty-nine (97 %) TARE patients received outpatient treatment. In contrast, 53 (98 %) TACE patients were hospitalized for ≥1 day (p < 0.001). Compared with TACE, TARE was more likely to induce fatigue (p = 0.003) but less likely to cause fever (p = 0.02).

Conclusion

There was no significant difference in efficacy between TARE and TACE. TARE patients reported more fatigue but had less fever than TACE patients. Treatment with TARE required less hospitalization than treatment with TACE. These findings require confirmation in randomized trials.

Keywords

ChemoembolizationEfficacyHepatocellular carcinomaRadioembolizationSafetyYttrium-90

Supplementary material

270_2012_481_MOESM1_ESM.tiff (1.9 mb)
Supplementary material 1 (TIFF 1973 kb)

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2012

Authors and Affiliations

  • Laura E. Moreno-Luna
    • 1
  • Ju Dong Yang
    • 1
  • William Sanchez
    • 1
  • Ricardo Paz-Fumagalli
    • 2
  • Denise M. Harnois
    • 3
  • Teresa A. Mettler
    • 1
  • Denise N. Gansen
    • 6
  • Piet C. de Groen
    • 1
  • Konstantinos N. Lazaridis
    • 1
  • K. V. Narayanan Menon
    • 1
  • Nicholas F. LaRusso
    • 1
  • Steven R. Alberts
    • 4
  • Gregory J. Gores
    • 1
  • Chad J. Fleming
    • 6
  • Seth W. Slettedahl
    • 5
  • William S. Harmsen
    • 5
  • Terry M. Therneau
    • 5
  • Gregory A. Wiseman
    • 6
  • James C. Andrews
    • 6
  • Lewis R. Roberts
    • 1
  1. 1.Division of Gastroenterology and HepatologyCollege of Medicine, Mayo ClinicRochesterUSA
  2. 2.Department of RadiologyCollege of Medicine, Mayo ClinicJacksonvilleUSA
  3. 3.Division of Gastroenterology and HepatologyCollege of Medicine, Mayo ClinicJacksonvilleUSA
  4. 4.Department of OncologyCollege of Medicine, Mayo Clinic and Mayo Clinic Cancer CenterRochesterUSA
  5. 5.Department of Health Sciences ResearchCollege of Medicine, Mayo ClinicRochesterUSA
  6. 6.Department of RadiologyCollege of Medicine, Mayo ClinicRochesterUSA