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Largest Multi-Centre Evaluation of Radioembolization Using Sir-Spheres for Patients With Inoperable Primary Liver Cancer Published in Hepatology
Date:7/7/2011

y on the state of their liver at the time of their diagnosis and the extent of tumour invasion.

Findings of the ENRY Evaluation

The majority of the patients (82.5%) evaluated by the ENRY group had liver disease that was reasonably-well compensated (Child-Pugh class A), with underlying cirrhosis (78.5%) and good ECOG Performance status (ECOG 0-1: 87.7%).  However, many of them had multiple tumour nodes (75.9%), with disease present in both lobes of the liver (53.1%) and/or occlusion of the portal vein (the vessel that transports blood from the gastrointestinal tract to the liver) in either a branch of the vein (13.5%) or the main vessel (9.8%).

Over 40 per cent of the patients (41.5%) had progressed following one or more other treatments prior to receiving radioembolization with SIR-Spheres (yttrium-90 resin microspheres; Sirtex Medical Limited, Sydney, Australia), including surgery or liver transplantation, percutaneous procedures such as ethanol injection or radiofrequency ablation of individual liver tumours, or vascular procedures such as transarterial embolisation (TAE) or chemoembolisation (TACE) that block the liver arteries that feed tumours.

Using Barcelona Clinic Liver Cancer (BCLC) staging criteria, the vast majority of patients evaluated by the ENRY group had either advanced (BCLC C: 56.3%) or intermediate (BCLC B: 26.8%) disease.

The patients who received radioembolization (also called selective internal radiation therapy or SIRT) were administered a median dose of 1.6 GBq of beta-radiating yttrium-90 resin microspheres, predominately as a single procedure delivered transarterially to the liver via a catheter through the femoral and hepatic arteries.  The median overall survival of the SIRT-treated patients evaluated by the ENRY group was 12.8 months.  Survival varied significantly by disease stage: 24.4 months for patients in BCLC A; 16.9 months in BCLC B; and 10.0 months in BCLC C.  

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