Kết quả điều trị 52 ca ung thư biểu mô tế bào gan bằng phương pháp tắc mạch xạ trị với hạt vi cầu gắn Yttrium-90

Abstract

Objective: To evaluate the effectiveness of radioembolization method with Yttrium-90 for the treatment of hepatocellular carcinoma. Subject and method: A prospective interventional uncontrolled study of 52 intermediate and advanced stage hepatocellular carcinoma patients having portal venous thrombosis with an average tumor size of 9.8 ± 3.0cm and treated by radioembolization with Yttrium-90 microspheres was conducted at 108 Military Central Hospital from October 2013 to September 2017. The survival from the first time of intervention and the 1-, 2-, 3- and 4-year survival rates were analysed by Kaplan Meier curves. In addition, clinical therapeutic response was assessed by both AFP levels and tumor response at follow-up times according to the mRECIST and RECICL criteria (2010). Result: There were 52 patients with 52 radioembolizational interventions with Yttrium-90 microspheres. The mean overall survival (OS) was 27.5 ± 2.9 months. The 1-, 2-, 3- and 4-year survival rates were 69.8%, 52.2%, 46.4% and 17.4%, respectively. Well-tolerated clinical improvement was recorded in 88.5% of patients; 55.2% of patients had a significant AFP level at three months after the procedure; the mean size of liver tumors decreased from 9.8 ± 3.0cm before treatment to 4.7 ± 2.7cm after 12 months of treatment (p<0.001); the overall response rate at 3 months was 50.0%, in which complete response and partial response were 13.5% and 36.5%, respectively. Conclusion: Radioembolization with Yttrium-90 microspheres for hepatocellular carcinoma treatment improves clinical response, AFP level, tumor response and good long-term survival after intervention.