Liver Decompensation as Late Complication in HCC Patients with Long-Term Response following Selective Internal Radiation Therapy

• Published in: Cancers Vol. 13; no. 21; p. 5427
• Main Authors: van Doorn, Diederick J., Hendriks, Pim, Burgmans, Mark C., Rietbergen, Daphne D. D., Coenraad, Minneke J., van Delden, Otto M., Bennink, Roel J., Labeur, Tim A., Klümpen, Heinz-Josef, Eskens, Ferry A. L. M., Moelker, Adriaan, Vegt, Erik, Sprengers, Dave, Mostafavi, Nahid, Ijzermans, Jan, Takkenberg, R. Bart
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 29.10.2021; MDPI
• Subjects: Cancer therapies; Hepatocellular carcinoma; Hypertension; Laboratories; Liver cancer; Liver diseases; Nuclear medicine; Parenchyma; Patients; Radiation therapy; Survival; Tumors
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers13215427

Selective internal radiation therapy (SIRT) is used as a treatment for hepatocellular carcinoma (HCC). The aim of this study was to assess long-term liver-related complications of SIRT in patients who had not developed radioembolization-induced liver disease (REILD). The primary outcome was the percentage of patients without REILD that developed Child-Pugh (CP) ≥ B7 liver decompensation after SIRT. The secondary outcomes were overall survival (OS) and tumor response. These data were compared with a matched cohort of patients treated with sorafenib. Eighty-five patients were included, of whom 16 developed REILD. Of the remaining 69 patients, 38 developed liver decompensation CP ≥ B7. The median OS was 18 months. In patients without REILD, the median OS in patients with CP ≥ B7 was significantly shorter compared to those without CP ≥ B7; 16 vs. 31 months. In the case-matched analysis, the median OS was significantly longer in SIRT-treated patients; 16 vs. 8 months in sorafenib. Liver decompensation CP ≥ B7 occurred significantly more in SIRT when compared to sorafenib; 62% vs. 27%. The ALBI score was an independent predictor of liver decompensation (OR 0.07) and OS (HR 2.83). After SIRT, liver decompensation CP ≥ B7 often developed as a late complication in HCC patients and was associated with a shorter OS. The ALBI score was predictive of CP ≥ B7 liver decompensation and the OS, and this may be a valuable marker for patient selection for SIRT.