Howard Dabbous, Sandra Gad, Michael Mohnasky, Alex Villalobos, David Brandon, Minzhi Xing, Nima Kokabi
{"title":"Tumor Dose as an Oncologic Predictor of Outcome in Patients with HCC Treated with Resin Y90 Microspheres.","authors":"Howard Dabbous, Sandra Gad, Michael Mohnasky, Alex Villalobos, David Brandon, Minzhi Xing, Nima Kokabi","doi":"10.1007/s00270-025-04113-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate tumor dose (TD) as a predictor of oncological outcomes in patients with hepatocellular carcinoma (HCC) treated with resin Y90 radioembolization (RE), and to evaluate non-tumoral liver dose (NTLD) as a predictor of treatment-related toxicity.</p><p><strong>Methods: </strong>A single-center retrospective review of treatment-naïve HCC patients who underwent resin-based Y90 between 2019 and 2022 was conducted. Baseline demographics, clinical history, and adverse events per CTCAE v5.0 were analyzed. Baseline imaging and post-treatment imaging were also evaluated using Response per Modified Response Evaluation Criteria in Solid Tumors (mRECIST) for tumor response.</p><p><strong>Results: </strong>78 patients (mean age:66.7 years) with 91 tumors underwent Y90-RE, with a median follow-up period of 28.3 months; 23 received lobar Y90-RE, while 55 patients received segmentectomies. Mean TD for the entire cohort was 336.6 ± 291.9 Gy. Mean TD was significantly higher in segmental Y90-RE (424.3 Gy) vs lobar Y90-RE (203.7 Gy) (p < 0.001). At 3 months, 98% of segmentectomy and 72% of lobar patients achieved an objective response (OR), with 90% and 40% achieving complete response (CR), respectively. At 6 months, 97% and 94% of segmentectomy patients achieved OR and CR, compared to 84% and 68% in lobar patients. Mean tumor dose > 250 Gy predicted prolonged overall and progression free survival. A mean NTLD dose of 103 Gy predicted grade 3 + adverse events in lobar treatments.</p><p><strong>Conclusion: </strong>In patients with HCC treated with resin-based Y90-RE, personalized dosimetry is a key factor in ensuring favorable oncological outcomes. Level of evidence Level 3b, retrospective cohort study.</p>","PeriodicalId":9591,"journal":{"name":"CardioVascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CardioVascular and Interventional Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00270-025-04113-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To evaluate tumor dose (TD) as a predictor of oncological outcomes in patients with hepatocellular carcinoma (HCC) treated with resin Y90 radioembolization (RE), and to evaluate non-tumoral liver dose (NTLD) as a predictor of treatment-related toxicity.
Methods: A single-center retrospective review of treatment-naïve HCC patients who underwent resin-based Y90 between 2019 and 2022 was conducted. Baseline demographics, clinical history, and adverse events per CTCAE v5.0 were analyzed. Baseline imaging and post-treatment imaging were also evaluated using Response per Modified Response Evaluation Criteria in Solid Tumors (mRECIST) for tumor response.
Results: 78 patients (mean age:66.7 years) with 91 tumors underwent Y90-RE, with a median follow-up period of 28.3 months; 23 received lobar Y90-RE, while 55 patients received segmentectomies. Mean TD for the entire cohort was 336.6 ± 291.9 Gy. Mean TD was significantly higher in segmental Y90-RE (424.3 Gy) vs lobar Y90-RE (203.7 Gy) (p < 0.001). At 3 months, 98% of segmentectomy and 72% of lobar patients achieved an objective response (OR), with 90% and 40% achieving complete response (CR), respectively. At 6 months, 97% and 94% of segmentectomy patients achieved OR and CR, compared to 84% and 68% in lobar patients. Mean tumor dose > 250 Gy predicted prolonged overall and progression free survival. A mean NTLD dose of 103 Gy predicted grade 3 + adverse events in lobar treatments.
Conclusion: In patients with HCC treated with resin-based Y90-RE, personalized dosimetry is a key factor in ensuring favorable oncological outcomes. Level of evidence Level 3b, retrospective cohort study.
期刊介绍：
CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.
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