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De la Garza-Ramos C, Overfield CJ, Montazeri SA, et al. Biochemical Safety of Ablative Yttrium-90 Radioembolization for Hepatocellular Carcinoma as a Function of Percent Liver Treated. J Hepatocell Carcinoma. 2021;8:861-870doi: 10.2147/JHC.S319215.
De la Garza-Ramos, C., Overfield, C. J., Montazeri, S. A., Liou, H., Paz-Fumagalli, R., Frey, G. T., McKinney, J. M., Ritchie, C. A., Devcic, Z., Lewis, A. R., Harnois, D. M., Patel, T., & Toskich, B. B. (2021). Biochemical Safety of Ablative Yttrium-90 Radioembolization for Hepatocellular Carcinoma as a Function of Percent Liver Treated. Journal of hepatocellular carcinoma, 8861-870. https://doi.org/10.2147/JHC.S319215
De la Garza-Ramos, Cynthia, et al. "Biochemical Safety of Ablative Yttrium-90 Radioembolization for Hepatocellular Carcinoma as a Function of Percent Liver Treated." Journal of hepatocellular carcinoma vol. 8 (2021): 861-870. doi: https://doi.org/10.2147/JHC.S319215
De la Garza-Ramos C, Overfield CJ, Montazeri SA, Liou H, Paz-Fumagalli R, Frey GT, McKinney JM, Ritchie CA, Devcic Z, Lewis AR, Harnois DM, Patel T, Toskich BB. Biochemical Safety of Ablative Yttrium-90 Radioembolization for Hepatocellular Carcinoma as a Function of Percent Liver Treated. J Hepatocell Carcinoma. 2021 Jul 30;8:861-870. doi: 10.2147/JHC.S319215. eCollection 2021. PMID: 34368021; PMCID: PMC8335548.
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J Hepatocell Carcinoma. 2021 Jul 30;8:861-870. doi: 10.2147/JHC.S319215. eCollection 2021.

Biochemical Safety of Ablative Yttrium-90 Radioembolization for Hepatocellular Carcinoma as a Function of Percent Liver Treated.

Journal of hepatocellular carcinoma

Cynthia De la Garza-Ramos, Cameron J Overfield, S Ali Montazeri, Harris Liou, Ricardo Paz-Fumagalli, Gregory T Frey, J Mark McKinney, Charles A Ritchie, Zlatko Devcic, Andrew R Lewis, Denise M Harnois, Tushar Patel, Beau B Toskich

Affiliations

  1. Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, FL, USA.
  2. Alix School of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA.
  3. Department of Transplant, Mayo Clinic Florida, Jacksonville, FL, USA.

PMID: 34368021 PMCID: PMC8335548 DOI: 10.2147/JHC.S319215

Abstract

PURPOSE: Transarterial radioembolization can serve as an ablative therapy for early-stage hepatocellular carcinoma (HCC). Given the volumetric variability of liver segments, this study aimed to characterize the safety of ablative radioembolization by determining percent liver treated (%LT) thresholds associated with biochemical toxicity.

PATIENTS AND METHODS: Patients with HCC receiving a single ablative radioembolization treatment using glass microspheres from 2017 through 2020 were reviewed. %LT was calculated as treatment angiosome volume divided by whole liver volume. Biochemical toxicities were defined as increases in Albumin-Bilirubin (ALBI) grade or Child-Pugh (CP) class compared to baseline and albumin or bilirubin adverse events (AEs) per the Common Terminology Criteria for Adverse Events. Receiver operating characteristic curves and multivariate logistic regression analyses were performed to assess the impact of %LT on toxicities.

RESULTS: Of 141 patients analyzed, 53% (n=75) were ALBI 1, 45% (n=64) ALBI 2, 79% (n=111) CP-A, and 21% (n=30) CP-B. A %LT ≥14.5% was associated with grade/class increases in ALBI 2 (

CONCLUSION: Patients with ALBI 2 and CP-B liver function are less likely to have an increase in their respective grade/class when treating <14.5% of the liver using glass microspheres. ALBI 1 and CP-A patients showed no definitive %LT threshold for biochemical toxicity within the range of this study.

© 2021 De la Garza-Ramos et al.

Keywords: Y-90; adverse events; hepatocellular carcinoma; radioembolization

Conflict of interest statement

BB Toskich is an advisor for Boston Scientific, Sirtex Medical, Johnson and Johnson, AstraZeneca, Genentech, Eisai, HistoSonics and Turnstone Biologics. The authors reported no other potential conflic

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