Table 4.
Overview of post-procedure course of patients who expired within 3 months post-radioembolization.
| Nr | Baseline patient characteristics |
Post-RAE course/potential reason of death | Death time |
|---|---|---|---|
| 1. | Hx of HAIP; >25%TB, bilobar liver disease; CEA= 766 ng/ml; EHD sites=2 | RAE-related major toxicity (grade 3 −4 chest pain, SOB, pleural effusion in face of stable lung metastases one-month post-RAE); managed conservatively. Death cancer-related, likely due liver failure with evidence of liver POD (one-month post-RAE) and EHD POD (lungs, lymph nodes). | 1.93 months |
| 2. | Hx of HAIP; bilobar liver disease, CEA=1357 ng/ml EHD sites=4 | RAE-related major toxicity: grade 4 SOB (acute hypersensitivity to steroids post-procedure), resolved. Cancer-related death in face of EHD POD one-month post-RAE and liver POD on first follow-up; Hx of hemochromatosis. | 1.53 months |
| 3. | Hx of liver Rx and HAIP; >25% TB, bilobar liver disease, CEA=228 ng/ml EHD sites=2 | Cancer-related death, likely due liver failure (ascites/grade 3 hyperbilirubinemia/anasarca) in face of liver POD (which precluded 2nd RAE session), lung POD and bilateral pulmonary embolism/pleural effusion/IVC and RHV thrombi 1-month post-RAE (treated with anticoagulation). | 2.93 months |
| 4. | Hx of HAIP; bilobar liver disease, CEA=218ng/ml | Unknown death reason; likely liver failure in face of RFA 1-month post-RAE with grade 4 hyperbilirubinemia/fever) | 2.27 months |
| 5. | Hx of liver Rx and HAIP; EHD sites=1; ECOG=1 | RAE contributed to fatal outcome (dramatic increased of LFTs right post-RAE); also, liver POD, secondary biliary obstruction, coagulopathy, colitis, duodenal stenosis, required stenting, HBV. | 1.27 months |
| 6. | Hx of HAIP, mitomycin, ≥3 chemotherapy lines, bilobar disease, CEA=4713ng/ml | Death reason unknown, likely liver failure in patient with history of hemochromatosis (2-months post-RAE admitted for abdominal pain in outside hospital with biliary stricture, cirrhosis, ascites). | 2.9 months |
| 7. | Hx of liver Rx, HAIP, ≥3 chemotherapy lines, bilobar disease, EHD sites=2 | Post-RAE: ECOG decline (from 0 to 3, 5-days post-RAE). Could not proceed with planned 2nd RAE session due grade 3 hyperbilirubinemia in face of liver POD on first follow-up. | 2.47 months |
| 8. | Hx of HAIP, ≥3 chemotherapy lines, bilobar disease, EHD sites=2 | Post-RAE: severe abdominal, back pain/anorexia/ SOB/chest pain/ phlegm 1- week post-RAE; 11 days post-RAE admitted for pneumonia, recovered. Death cancer-related (although no records within 3 weeks before death). | 1.83 months |
| 9. | Bilobar disease, CEA=130 ng/ml, EHD sites=2, ECOG=1 | Death cancer-related in face of untreated liver POD, peritoneal carcinomatosis and not-RAE related adverse event (6 weeks post-RAE obstruction due stomach bleed (patient was on Xarelto) requiring transfusion; significant ECOG decline. | 1.77 months |
| 10. | Bilobar disease, EHD sites=2 ECOG=1 | Grade 3–4 toxicity: Post-embolization syndrome. Six weeks post-RAE urosepsis, 2 months post-RAE: brain radiotherapy for brain metastases, then altered mental status/ hypoxia due fluid overload, leptomeningeal metastases. | 2.13 months |
| 11. | Hx of HAIP; bilobar disease, CEA=404 ng/ml; EHD sites=1 | No report of RAE-related toxicity and other adverse events after RAE. | 2.3 months |
Hx-history, Rx-resection, RAE-radioembolization, TB-tumor burden, CEA-carcinoembryonic antigen level, EHD-extrahepatic disease, POD-progression of disease, RT-radiotherapy, ECOG-performance status, IVC-inferior vena cava, RHV-right hepatic vein, RFA-radiofrequency ablation, LFTs- liver function tests