Article Figures & Data
Figures
- FIGURE 1.
Consort diagram of patient enrollment. CECT = contrast-enhanced CT; HCC = hepatocellular carcinoma; SIRT = selective internal radiation therapy.
- FIGURE 2.
Lesion-based (A) and patient-based (B) comparisons of MAD for tumors among groups with CR, PR, SD, and PD. Horizontal line embedded in scatterplot is median value of each group. No CR response per patient was observed. There were no significant differences among PR, SD, and PD groups per patient. *P < 0.01; each value was compared using Mann–Whitney test.
- FIGURE 3.
Receiver operating characteristic comparison of tumor response to radioembolization in terms of MAD for tumors to classify responder group vs. nonresponder group per lesion (A, 126 lesions) and per patient (B, 28 patients).
Tables
Clinical variable Value Age (y) Median, 60; range, 35–77 Male/female (n) 24/19 Origin of tumor: pancreas/gastrointestinal/unknown 11/30/2 NEN grade: 1/2/3 14/26/3 Endocrine syndrome: positive/negative (n) 12/31 Liver cirrhosis: positive/negative (n) 1/42 Extrahepatic lesions: positive/negative (n) 19/24 Number of involved regions: 1/2/3/4 (n)* 12/4/2/1 Lymph node/thyroid gland/lung (n) 14/1/3 Adrenal gland/peritoneum/ovary/bone (n) 1/5/2/4 Partial-liver/whole-liver SIRT (n) 6†/37 Sessions for whole-liver SIRT: 1/2 (n) 29/8 Treated volume (mL) Median, 1,735.4; range, 828.6–6,377.3 Treated fraction (%) Median, 100; range, 61.4–100 Administered dose (GBq) Median, 3.9; range, 2.1–22.0 MIRD dose (Gy) Median, 107.1; range, 44.8–164.3 MAD (Gy) Median, 219.5; range, 48.1–1014.6 Perfused volume normal-tissue AD (Gy) Median, 96.2; range, 13.7–181.0 Whole-liver normal-tissue AD (Gy) Median, 95.3; range, 13.6–181.1 Lung shunt fraction (%) Median, 2.9; range, 0.7–29.0 PV thrombosis: Vp1–Vp3/Vp4/negative (n) 1/0/42 Prior therapy (n) 40 Number of therapies: 0/1/2/3/4/5 (n)‡ 3/9/11/11/4/5 Tumor resection: primary/liver metastasis (n) 34/8 TACE/RFA/radiotherapy (n) 5/3/1 Somatostatin/PRRT/systemic therapy (n) 29/12/13 After SIRT (n) 38 Number of therapies: 0/1/2/3/4/5 (n)‡ 5/17/14/4/2/1 Tumor resection: primary/liver metastasis (n) 1/2 TACE/RFA/radiotherapy (n) 2/0/0 Somatostatin/PRRT/systemic therapy (n) 28/16/18 Additional SIRT (≥6 mo later) (n) 3 ↵* Number of involved regions per patient.
↵† Four and 2 patients underwent radioembolization for right lobe and right lobe plus medial segment, respectively.
↵‡ Number of therapies per patient.
SIRT = selective internal radiation therapy; AD = absorbed dose; PV = portal vein; TACE = transarterial chemoembolization; RFA = radiofrequency ablation. PRRT = peptide receptor radionuclide therapy; systemic therapy = mammalian target of rapamycin inhibitor or chemotherapy.
- TABLE 2.
Uni- and Multivariate Cox Proportional Hazards Regression Analyses for Hepatic and Global PFS and OS
Survival type Grade Univariate Multivariate HR P HR P Hepatic PFS NEN grade Grade 2 vs. 1 4.02 (1.31–12.32) 0.015 3.90 (1.26–12.07) 0.018 Grade 3 vs. 1 3.74 (0.67–20.97) 0.13 4.43 (0.78–25.35) 0.094 Tumor origin 2.66 (1.05–6.76) 0.040 2.65 (1.01–6.93) 0.048 MAD 0.999 (0.997–1.001) 0.29 Global PFS NEN grade Grade 2 vs. 1 2.49 (1.04–5.96) 0.040 2.51 (1.04–6.09) 0.042 Grade 3 vs. 1 36.53 (6.71–198.93) <0.001 62.44 (9.96–391.48) <0.001 Tumor origin 2.47 (1.14–5.33) 0.021 6.58 (2.50–17.36) <0.001 MAD 0.998 (0.997–1.000) 0.0498 0.998 (0.996–0.999) 0.003 OS NEN grade Grade 2 vs. 1 1.82 (0.85–3.86) 0.12 1.81 (0.84–3.87) 0.13 Grade 3 vs. 1 3.88 (1.03–14.63) 0.045 3.15 (0.82–12.12) 0.095 Tumor origin 1.93 (0.88–4.22) 0.099 MAD 0.998 (0.996–1.000) 0.049 0.998 (0.997–1.0002) 0.072 Data are for 43 patients and for 24, 33, and 35 events for hepatic PFS, global PFS, and OS, respectively. Data in parentheses are 95% CIs. Prognostic parameters with P < 0.05 in univariate analysis entered multivariate analysis.
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