PURPOSE The management of Renal cell carcinoma (RCC) patients with liver metastases is challenging. Liver-directed therapy, such as Transarterial radioembolization (TARE), is a reasonable option for these patients; however, its safety and efficacy are not well characterized. This study evaluated the safety and efficacy of TARE in patients with liver-dominant metastatic RCC. MATERIALS AND METHODS This is a retrospective, single-center study. Thirty-eight patients' medical records were reviewed who underwent TARE between January 1, 2009, and December 31, 2019, in a tertiary cancer center. Two were excluded from further analysis. Thirty-six patients received 51 TARE treatments. Median follow-up time was 18.2 months. Imaging data were evaluated using mRECIST or RECIST 1.1 criteria. Toxicities, treatment responses, liver progression-free survival (LPFS), and median overall survival (OS) were calculated. Univariate and multivariate analyses were conducted to reveal predictors of OS. RESULTS Median OS from TARE was 19.3 months (95% CI, 22.6-47.4) and from diagnosis of liver metastases was 36.5 months (95% CI: 26.4-49.8). Mild, grade 1 or 2, biochemical toxicity developed in 27 patients (75%). Grade 3-4 toxicity was noted in two patients (5.5%). The objective response rate was 89%; the disease control rate was 94% (21 complete response, 11 partial response, two stable disease, and two progressive disease). Univariate and multivariate analyses showed longer survival in patients who had objective response, lower lung shunt fraction, and better baseline liver function. CONCLUSIONS TARE is safe and effective and led to promising overall survival in patients with liver-dominant metastatic RCC. LEVEL OF EVIDENCE Level 3, retrospective cohort study.

中文翻译：

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放射栓塞在肝转移性肾细胞癌治疗中的作用：单中心回顾性研究。

目的 肝转移肾细胞癌 (RCC) 患者的管理具有挑战性。肝脏定向治疗，如经动脉放射栓塞 (TARE)，是这些患者的合理选择；然而，其安全性和有效性尚未得到很好的表征。本研究评估了 TARE 在肝主导的转移性 RCC 患者中的安全性和有效性。材料和方法 这是一项回顾性、单中心研究。对 2009 年 1 月 1 日至 2019 年 12 月 31 日期间在三级癌症中心接受 TARE 的 38 名患者的医疗记录进行了审查。两个被排除在进一步分析之外。36 名患者接受了 51 次 TARE 治疗。中位随访时间为 18.2 个月。使用 mRECIST 或 RECIST 1.1 标准评估成像数据。毒性，治疗反应，计算肝脏无进展生存期（LPFS）和中位总生存期（OS）。进行单变量和多变量分析以揭示 OS 的预测因素。结果 TARE 的中位 OS 为 19.3 个月（95% CI，22.6-47.4），肝转移诊断的中位 OS 为 36.5 个月（95% CI：26.4-49.8）。27 名患者 (75%) 出现轻度的 1 级或 2 级生化毒性。两名患者 (5.5%) 出现 3-4 级毒性。客观反应率为89%；疾病控制率为94%（完全缓解21例，部分缓解11例，病情稳定2例，疾病进展2例）。单变量和多变量分析显示，客观反应、肺分流分数较低和基线肝功能较好的患者生存期更长。结论 TARE 是安全有效的，并且在以肝为主的转移性 RCC 患者中具有有希望的总生存期。证据水平 3 级，回顾性队列研究。