Table 3.
Summary of evidence for radioembolization (90Y)
| Authors | n | Summary |
|---|---|---|
| Salem, et al. [32] (2005) | 43 | 90Y for unresectable hepatocellular carcinoma: safety, tumor reponse and survival in segmental, lobar low risk and lobar high risk groups, Okuda and Childs-pugh scoring systems. |
| 47% objective tumor response based on percent reduction in tumor size | ||
| 79% tumor response based on percent reduction and/or tumor necrosis as a composite measure | ||
| Significant difference in survival in segmental (46.5months), lobar low risk (16.9 months), lobar high risk (11.1 months) (P<0.0001) | ||
| No significant difference in tumor response between segmental, lobar low risk and lobar high risk groups. | ||
| Median survival of Okuda I (24.4 months), Okuda II (12.5 months), Childs A (20.5 months), Childs B/C (13.8 months). | ||
| Lau, et al. [36] (1998) | 71 | Intraarterial infusion of 90Y microspheres for non resectable hepatocellular carcinoma |
| 50% reduction in tumor volume in 26.7% patients after first treatment | ||
| Partial response 67%, complete response 22%, in patients with elevated AFP. | ||
| Decrease in serum ferritin by 34-99% after treatment, in pateints without elevated AFP. | ||
| Median survival 9.4 months, range 1.8-46.4 months | ||
| Kulik, et al. [37] (2006) | 150 | 90Y for unresectable hepatocellular carcinoma: downstaging to resection, RFA, bridge to transplantation. |
| 56% were downstaged from UNOS T3 to T2 after treatment | ||
| 32% were downstaged to target lesions <3.0 cm | ||
| 66% were downstaged to UNOS T2, lesion <3.0 cm (RFA candidate) or resection. | ||
| 50% had an objective tumor response by WHO criteria | ||
| 23% were downstaged and underwent OLT after treatment. | ||
| 1,2 and 3 year survival was 84%, 54% and 27%. | ||
| Median survival for entire cohort = 800 days. | ||
| Salem, et al. [30] (2016) | 179 | 90Y vs conventional TACE |
| Significantly longer median time to progression in Y90 patients than cTACE patients (>26 months, 6.8 months, P=0.0012) | ||
| TACE group had significantly higher diarrhea (21% vs 0%, P=0.031), hypoalbuminemia (58% vs 4%, P<0.001). | ||
| Similar response to therapy, marked by necrosis in both groups (P=0.433) | ||
| Median survival time, censored to liver transplantation was 17.7 months for TACE group vs 18.6 months for 90Y group (P=0.99) | ||
| Lobo, et al. [40] (2016) | 533 | Systematic review and meta-analysis of radioembolization (TARE) vs chemoembolization (TACE) |
| No significant difference in survival up to 4 years between the two groups (P=0.567) | ||
| TACE had more post treatment pain than TARE (P<0.01), less subjective fatigue (P<0.01). | ||
| No difference between the two groups with post treatment nausea, vomiting, fever or other complications. | ||
| No significant difference in partial or complete response between the two groups. |