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Hepatogastroenterology ; 61(134): 1529-34, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25436337

RESUMEN

INTRODUCTION: Locoregional treatments, such as radioembolization, can be used to treat patients with unresectable liver metastases. We aimed to determine the progression-free survival and factors that predict survival of patients with liver metastases whose response to selective internal radiation therapy (SIRT) with Y-90 was assessed by positron emission tomography-computed tomography (PET-CT). PATIENTS: Our study included 78 liver cancer patients who were treated with Y-90 radioembolization. RESULTS: The post-treatment response rates were as follows: 7 patients (9%) had stable disease (SD), 26 patients (33.3%) had a partial response (PR), 4 patients (5.1%) had a complete response (CR). The median hepatic progression-free survival (HPFS) was 4.4 months while median overall survival was 10.1 months. Univariate analysis revealed that HPFS is significantly affected by international normalized ratio (INR) levels and age (Hazard Ratio(HR)=0.54 (95%CI:0.30-096), P=0.034, HR=1.03(95%CI:1.00-1.05), P=0.051). However, only INR levels retained significance with multivariate analysis (HR=0.53 (95%CI:0.30-0.93), P=0.028), while age had limited significance (HR =1.02 (95% CI:1.00-1.05), P=0.051). CONCLUSIONS: We determined that Y-90 radioembolization is effective as a salvage therapy in patients with predominant liver metastases. For the first time, we showed that age and INR values reflecting the functional hepatic reserve can be used as positive predictive factors for HPFS.


Asunto(s)
Embolización Terapéutica/métodos , Neoplasias Hepáticas/radioterapia , Neoplasias Hepáticas/secundario , Radiofármacos/uso terapéutico , Radioisótopos de Itrio/uso terapéutico , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Supervivencia sin Enfermedad , Embolización Terapéutica/efectos adversos , Embolización Terapéutica/mortalidad , Femenino , Humanos , Relación Normalizada Internacional , Estimación de Kaplan-Meier , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/mortalidad , Masculino , Persona de Mediana Edad , Imagen Multimodal/métodos , Análisis Multivariante , Tomografía de Emisión de Positrones , Valor Predictivo de las Pruebas , Modelos de Riesgos Proporcionales , Radiofármacos/efectos adversos , Factores de Riesgo , Terapia Recuperativa , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Radioisótopos de Itrio/efectos adversos
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