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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.04.2016 | Original Article

Selective internal radiation therapy compared with sorafenib for hepatocellular carcinoma with portal vein thrombosis

verfasst von: Julien Edeline, Laurence Crouzet, Boris Campillo-Gimenez, Yan Rolland, Marc Pracht, Anne Guillygomarc’h, Karim Boudjema, Laurence Lenoir, Xavier Adhoute, Tanguy Rohou, Eveline Boucher, Bruno Clément, Jean-Frédéric Blanc, Etienne Garin

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 4/2016

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Abstract

Purpose

Tumoural portal vein thrombosis (PVT) is a major prognostic factor in hepatocellular carcinoma (HCC). The efficacy of sorafenib, the only treatment approved at an advanced stage, is limited. Based on previous data, selective internal radiation therapy (SIRT), or ⁹⁰Y radioembolization, seems an interesting option. We aimed to compare both treatments in this population.

Methods

We retrospectively compared patients treated in two centres for HCC with tumoural PVT. We compared overall survival (OS) between patients treated with SIRT and patients treated with sorafenib. Analyses were performed before and after 1:1 matching with a propensity score for controlling indication bias, using a Cox proportional hazards model.

Results

A total of 151 patients were analysed, 34 patients treated with SIRT and 117 patients treated with sorafenib only. In the whole population, SIRT was associated with a higher median OS as compared with sorafenib: 18.8 vs 6.5 months (log-rank p < 0.001). There was an imbalance of baseline characteristics between patients treated by SIRT and sorafenib, which justified patient matching with use of a propensity score: 24 patients treated with SIRT could be matched with 24 patients treated with sorafenib. OS was estimated with a median of 26.2 vs 8.7 months in patients treated with SIRT vs sorafenib, respectively (log-rank p = 0.054). Before and after patient matching, the adjusted hazard ratio related to treatment by SIRT was estimated at 0.62 [95 % confidence interval (CI) 0.39–0.97] (p = 0.037) and 0.40 (95 % CI 0.19–0.82) (p = 0.013), respectively.

Conclusion

SIRT seems more effective than sorafenib in patients presenting with HCC and tumoural PVT. This hypothesis is being tested in prospective randomized trials.

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Titel: Selective internal radiation therapy compared with sorafenib for hepatocellular carcinoma with portal vein thrombosis
verfasst von: Julien Edeline
Laurence Crouzet
Boris Campillo-Gimenez
Yan Rolland
Marc Pracht
Anne Guillygomarc’h
Karim Boudjema
Laurence Lenoir
Xavier Adhoute
Tanguy Rohou
Eveline Boucher
Bruno Clément
Jean-Frédéric Blanc
Etienne Garin
Publikationsdatum: 01.04.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 4/2016
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-015-3210-7

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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