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Golfieri R, Bilbao JI, Carpanese L, Cianni R, Gasparini D, Ezziddin S, Paprottka PM, Fiore F, Cappelli A, Rodriguez M, Ettorre GM, Saltarelli A, Geatti O, Ahmadzadehfar H, Haug AR, Izzo F, Giampalma E, Sangro B, Pizzi G, Notarianni E, Vit A, Wilhelm K, Jakobs TF, Lastoria S; on behalf of the European Network on Radioembolization with Yttrium-90 Microspheres (ENRY) study collaborators. J Hepatol. 2013 May 23. pii: S0168-8278(13)00356-5. doi: 10.1016/j.jhep.2013.05.025. [Epub ahead of print |
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Source
Azienda Ospedaliero-Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy;Rita Golfieri: Department of Digestive Diseases and Internal Medicine Alberta Cappelli: Interventional Radiology, Emanuela Giampalma: Interventional Radiology. Electronic address: rita.golfieri@unibo.it.
Abstract
BACKGROUND & AIMS:
The European Network on Radioembolization with Yttrium-90 resin microspheres study group (ENRY) conducted a retrospective study to evaluate the outcomes among elderly (⩾70 years) and younger patients (<70 years) with unresectable hepatocellular carcinoma (HCC) who received radioembolization at 8 European centers.
METHODS:
Patients with confirmed diagnosis of unresectable HCC who either progressed following resection or locoregional treatment and/or who were considered poor candidates for chemoembolization were evaluated by a multidisciplinary team for radioembolization with 90Y-resin microspheres (SIR-Spheres; Sirtex Medical). The survival outcome and all adverse events were compared between the two age groups.
RESULTS:
Between 2003 and 2009, 128 elderly and 197 younger patients received radioembolization. Patients in both groups had similar demographic characteristics. Many elderly and younger patients alike had multinodular, BCLC stage C disease, invading both lobes (p=0.648). Elderly patients had a lower tumor burden, a smaller median target liver volume (p=0.016) and appeared more likely to receive segmental treatment (p=0.054). Radioembolization was equally well tolerated in both cohorts and common procedure-related adverse events were predominantly grade 1-2 and of short duration. No significant differences in survival between the groups were found (p=0.942) with similar median survival in patients with early, intermediate or advanced BCLC stage disease.
CONCLUSIONS:
Radioembolization appears to be as well-tolerated and effective for the elderly as it is for younger patients with unresectable HCC. Age alone should not be a discriminating factor for the management of HCC patients.
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