Background

Few studies have assessed the relationship between serum alpha-fetoprotein (AFP) and yttrium-90 (Y-90) radioembolization response in hepatocellular carcinoma (HCC). The objective of the study was to evaluate whether peri-procedural serum AFP was correlated with Y-90 therapy response in HCC.

Methods

Patients undergoing Y-90 radioembolization with glass microspheres (TheraSphere™) for HCC between 2006 and 2013 at a single center were evaluated. The relationship between AFP and 6-month radiographic improvement (complete or partial response by modified RECIST criteria), overall (OS), and disease-specific survival (DSS) were analyzed.

Results

Seventy-four patients underwent a total of 124 Y-90 infusions. Median age was 65 years, median AFP was 37 ng/mL (range: 2–112,593 ng/mL) and median model for end-stage liver disease score was 6.2 (range:1.8–11.2). Increased AFP was not associated with radiographic improvement (odds ratio (OR) = 0.99, 95% confidence interval (CI) = 0.75–1.30, p = 0.92). Median OS was 15.2 months and was increased in patients with low AFP compared to high AFP (30.8 months vs. 7.8 months, p < 0.001). On multivariable regression analysis, increased AFP was associated with worse OS (OR = 1.11, 95%CI = 1.01–1.22, p = 0.034) and DSS (OR = 1.13, 95%CI = 1.03–1.25, p = 0.018).

Conclusion

Pre-infusion AFP independently predicted survival after Y-90 treatment for HCC, but not radiographic response, and can help guide treatment decisions.

中文翻译：

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将肝细胞癌中的血清甲胎蛋白与玻璃微球 (TheraSphere™) 对 Yttrium-90 经动脉放射栓塞的反应相关联。

背景

很少有研究评估肝细胞癌 (HCC) 中血清甲胎蛋白 (AFP) 和钇 90 (Y-90) 放射栓塞反应之间的关系。该研究的目的是评估围手术期血清 AFP 是否与 HCC 中的 Y-90 治疗反应相关。

方法

评估了 2006 年至 2013 年间在单个中心接受玻璃微球 (TheraSphere™) Y-90 放射栓塞治疗 HCC 的患者。分析了 AFP 与 6 个月影像学改善（根据修改后的 RECIST 标准的完全或部分反应）、总体 (OS) 和疾病特异性生存 (DSS) 之间的关系。

结果

74 名患者总共接受了 124 次 Y-90 输注。中位年龄为 65 岁，中位 AFP 为 37 ng/mL（范围：2–112,593 ng/mL），终末期肝病评分中位模型为 6.2（范围：1.8–11.2）。AFP 增加与影像学改善无关（优势比 (OR) = 0.99, 95% 置信区间 (CI) = 0.75–1.30, p = 0.92）。中位 OS 为 15.2 个月，与高 AFP 相比，低 AFP 患者的 OS 增加（30.8 个月对 7.8 个月，p < 0.001）。在多变量回归分析中，AFP 增加与较差的 OS（OR = 1.11, 95%CI = 1.01–1.22, p = 0.034）和 DSS（OR = 1.13, 95%CI = 1.03–1.25, p = 0.018）相关。

结论

输注前 AFP 可独立预测 Y-90 治疗 HCC 后的生存率，但不能预测放射学反应，并可帮助指导治疗决策。