Nuke med intervention safe, effective against advanced liver cancer

Patients who have advanced liver cancer with blockage or narrowing of the blood vessel that brings blood to the liver from the intestines—i.e., portal vein thrombosis—are safely and effectively treated by interventional radiologists administering the isotope yttrium-90 (Y90) for radioembolization, according to a study conducted at Northwestern University and published online Dec. 7 in the Journal of Nuclear Medicine.

Senior author Riad Salem, MD, and colleagues looked at 185 patients who had advanced-stage hepatocellular carcinoma with tumor portal vein thrombosis and were treated with Y90 at Northwestern Memorial Hospital in Chicago over nearly a decade and a half.

The team analyzed clinical and lab data collected at baseline and one month after the radioembolization procedure, then calculated long-term and overall survival rates.

Conducting a sub-analysis of patients with high levels of the tumor marker alpha-fetoprotein (AFP), they found that marker and several other lab results used for staging chronic liver disease were strongly predictive of outcomes.

Of 123 patients with high AFP, 12 patients returned to normal AFP levels following the intervention and exhibited median overall survival of 23.9 months.

Meanwhile, patients with the lowest staging scores had overall survival of 13.3 months, those with the highest scores had overall survival of 3.9 months, and a middle group had overall survival of 6.9 months.

“Y90 radioembolization can serve as a safe and effective treatment for advanced stage hepatocellular carcinoma patients with tumor portal vein thrombosis,” Salem et al. conclude. “Overall survival outcomes are affected by baseline liver function, tumor size and AFP level.”