Radioembolization-Induced Chronic Hepatotoxicity: A Single-Center Cohort Analysis. Academic Article uri icon

Overview

abstract

  • PURPOSE: To identify and characterize the delayed effects of transarterial radioembolization (TARE) on the liver. MATERIALS AND METHODS: A single-institution retrospective analysis was undertaken of all patients who received TARE between 2005 and 2014 and survived at least 1 year from the initial TARE (n = 106). Patients were evaluated for the presence or absence of radioembolization-induced chronic hepatotoxicity (RECHT) occurring at least 6 months after TARE. The mean age of patients was 63 years of age, and the malignancy most commonly treated was neuroendocrine tumor (54%). Adjudication of hepatic decompensation to RECHT versus alternative causes was performed by a multidisciplinary panel of specialists from hepatology, radiation oncology, and interventional radiology. RESULTS: Eight patients were excluded from analysis because of liver transplantation (2) or incomplete data (6). RECHT occurred in 13 of 98 patients (13%), and 5 deaths (5%) occurred from hepatic decompensation. There were a total of 69 toxicity events in patients developing RECHT. The most common events were elevation of alkaline phosphatase (10), decrease in serum albumin (10), and development of ascites (9). RECHT patients had a higher intrahepatic tumor volume (P = .021) and a higher number of hepatic comorbidities leading to cirrhosis (P = .015). CONCLUSIONS: Delayed radiation-induced hepatic toxicity occurred in 13% of patients following radioembolization, with 5 fatalities adjudicated to be a result of the treatment. Tumor involvement of greater than 50% of the liver and cirrhosis were predisposing factors for RECHT.

publication date

  • July 26, 2019

Research

keywords

  • Embolization, Therapeutic
  • Liver Diseases
  • Liver Neoplasms
  • Radiation Exposure
  • Radiation Injuries
  • Radiopharmaceuticals

Identity

Scopus Document Identifier

  • 85069655491

Digital Object Identifier (DOI)

  • 10.1016/j.jvir.2019.06.003

PubMed ID

  • 31353191

Additional Document Info

volume

  • 30

issue

  • 12