Background/Objectives: The aim of this study was to assess the efficacy of boosted dose yttrium-90 radioembolization (TARE) as a modality for conversion therapy to transplant or surgical resection in patients with unresectable hepatocellular carcinoma (HCC). Methods: In this single-center retrospective study, all patients with a diagnosis of HCC who were treated with boosted dose TARE (>190 Gy) between January 2013 and December 2023 were reviewed. Treatment response and decrease in tumor size were assessed with the RECIST v1.1 and mRECIST criteria. Milan and University of California, San Francisco (UCSF), criteria were used to determine transplant eligibility, and Barcelona Clinic Liver Cancer (BCLC) surgical resection recommendations were used to evaluate tumor resectability. Results: Thirty-eight patients with primary HCC who were treated with boosted dose TARE were retrospectively analyzed. The majority of the patients were Child–Pugh A (n= 35; 92.1%), BCLC C (n= 17; 44.7%), and ECOG performance status 0 (n= 25; 65.8%). The mean sum of the target lesions was 6.0 cm (standard deviation; SD = 4.0). The objective response rate (ORR) was 31.6% by RECIST and 84.2% by mRECIST. The disease control rate (DCR) was 94.7% by both RECIST and mRECIST. Among patients outside of Milan or UCSF, 13/25 (52.0%, Milan) and 9/19 (47.4%, UCSF) patients were successfully converted to within transplant criteria. Of patients who were initially unresectable, conversion was successful in 7/26 (26.9%) patients. Conclusions: This study provides further real-world data demonstrating that boosted-dose TARE is an effective modality for conversion of patients with unresectable HCC to transplant or resection.
背景/目的：本研究旨在评估强化剂量钇-90放射栓塞治疗（TARE）作为转化治疗手段，使不可切除肝细胞癌（HCC）患者获得肝移植或手术切除机会的疗效。方法：本单中心回顾性研究纳入了2013年1月至2023年12月期间接受强化剂量TARE（>190 Gy）治疗的所有HCC患者。采用RECIST v1.1和mRECIST标准评估治疗反应及肿瘤缩小情况。使用米兰标准和加州大学旧金山分校（UCSF）标准评估肝移植适宜性，并依据巴塞罗那临床肝癌（BCLC）分期系统的肝切除建议评估肿瘤可切除性。结果：共对38例接受强化剂量TARE治疗的原发性HCC患者进行回顾性分析。大多数患者为Child-Pugh A级（n=35；92.1%）、BCLC C期（n=17；44.7%）和ECOG体能状态评分0分（n=25；65.8%）。靶病灶总直径平均值为6.0厘米（标准差SD=4.0）。客观缓解率（ORR）按RECIST标准为31.6%，按mRECIST标准为84.2%。疾病控制率（DCR）按两种标准均为94.7%。在超出米兰标准或UCSF标准的患者中，分别有13/25例（52.0%，米兰标准）和9/19例（47.4%，UCSF标准）成功转化为符合移植标准。在初始不可切除的患者中，7/26例（26.9%）成功转化为可切除状态。结论：本研究提供了进一步的真实世界数据，证明强化剂量TARE是促使不可切除HCC患者转化为适合移植或切除的有效治疗方式。
肿瘤(癌症)患者之家