Aaron Rohr, Benjamin Haverkamp, William Pedersen, Joseph Vavricek, Saad Iqbal, Jill Jones, Thomas Fahrbach, Suzanne Hunt, Jo Wick, Carissa Walter, Jacqueline Hill and Zachary Collins
Introduction: To compare tumor response, time-to-progression (TTP), and progression-free survival (PFS) between glass and resin yttrium-90 (Y-90) treatment of hepatocellular carcinoma (HCC) in patients with and without portal vein invasion (PVI). Methods: Retrospective analysis was conducted on HCC patients who received Y-90 treatments from 2008-2014. Three readers evaluated response using mRECIST criteria. TTP was calculated as days from diagnosis to progression, while PFS was calculated as days from first treatment to progression. Progression was defined as >=20% increase in baseline enhancing tissue or presence of new lesions. Fisher’s Exact Test was used to calculate association of treatment with response, while Kaplan-Meier curves, log-rank tests, and hazard ratios (HRs) were used to calculate TTP and PFS. Results: Forty-eight patients received 78 treatments – 58.3% (n=28) received glass and 41.7% (n=20) received resin. There was no significant difference in tumor response by treatment group or PVI. Overall, 67.9% of glass and 80.0% of resin patients demonstrated disease control (any response except progressive disease) within one year of first Y-90 treatment (OR=1.9, 95% CI=0.5-8.1). Moreover, 62.5% of glass and 91.7% of resin patients with PVI (OR=6.6, 95% CI=0.9-136.3) and 75.0% of glass and 62.5% of resin patients without PVI (OR=0.6, 95% CI=0.1-4.0) demonstrated disease control. Mean TTP was 319.4 days (SE=16.8) and 180.9 days (SE=3.0) for glass and resin patients, respectively (HR=0.89, 95% CI=0.21-3.72, p=0.87). Mean PFS was 135.5 days (SD=12.0) and 173.0 days (SD=7.5) for glass and resin patients, respectively (HR=0.52, 95% CI=0.16-1.68, p=0.27). Conclusions: This study suggests similar one-year response, TTP, and PFS for HCC patients with and without PVI receiving glass and resin Y-90 treatments.
