Survival and response after selective internal radiation therapy (SIRT) for advanced hepatocellular carcinoma with and without portal vein thrombosis

160 Objectives Selective internal radiation therapy (SIRT) with Y-90 microspheres is a treatment option of hepatocellular carcinoma (HCC). Our aim was to evaluate the efficacy and safety of SIRT with Y-90 glass microspheres in patients with advanced HCC with and without portal vein thrombosis. Methods We enroled 60 patients with advanced HCC for this study. Exclusion criteria of SIRT were: tumour/liver-ratio > 60%, extrahepatic metastases and a significant hepatopulmonary shunt-fraction. Between 11/06 and 10/08, 60 patients with advanced HCC were included in this prospective study. 56/60 patients had liver cirrhosis, with Child-Pugh scores between 5 and 9. We enroled 19 patients with pre-therapeutic portal vein thrombosis. Therapy monitoring included sequential CT-scans 3, 6 und 9 months after therapy, measurements of serum a-fetoprotein (AFP) 30 und 90 days after therapy. Results At present data of 40 patients have been analyzed six months after therapy. According to RECIST criteria we observed a stable disease (SD, SD= 20/40) or partial response (PR, PR= 11/40) in 80% of the patients. There was no difference in posttherapeutical survival in the subgroups with or without portal vein thrombosis. Liver toxicities were more common in patients with portal vein thrombosis. Conclusions Radioembolization with Y-90 glass microspheres is a safe and effective treatment for patients with advanced HCC even in case of portal vein thrombosis.