• J Formos Med Assoc · Apr 2021

    Prediction of survival according to kinetic changes of cytokines and hepatitis status following radioembolization with yttrium-90 microspheres.

    • Chien-An Liu, I-Cheng Lee, Rheun-Chuan Lee, Jian-Ling Chen, Yee Chao, Ming-Chih Hou, and Yi-Hsiang Huang.
    • Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
    • J Formos Med Assoc. 2021 Apr 1; 120 (4): 1127-1136.

    Background/PurposeYttrium-90 radioembolization (Y90-RE) may exert an immunomodulatory effect on the tumor microenvironment of hepatocellular carcinoma (HCC). Whether the host immune alterations after Y90-RE correlated with outcomes and whether Y90-RE affects viral hepatitis reactivation remains unclear.MethodsBetween July 2014 and July 2015, 18 patients undergoing Y90-RE for HCC were prospectively enrolled. Serum levels of virological markers, cytokines and chemokines were measured at baseline, 2, 4, and 12 weeks after Y90-RE. Factors associated with the clinical outcomes were evaluated.ResultsThe disease control rate of Y90-RE was 44.4% (8 of 18) at 12 weeks, including 1 case with complete response, 4 cases with partial response, and 3 cases with stable disease. Significant elevation from baseline to week 2 and week 4 were noted in IL-10 level (8.4 ± 33.8, 15.7 ± 31.6, and 16.0 ± 41.7 pg/mL, P = 0.041 and 0.013, respectively) and IP-10 level (113.5 ± 97.8, 189.1 ± 164.4, and 168.6 ± 150.5 pg/mL, P = 0.027 and 0.026, respectively). After Y90-RE, transient HBV reactivation occurred in 2 patients, and 1 out of 3 HCV-infected patients exhibited HCV reactivation. Univariate analysis revealed that lower baseline IP-10 (≤200 pg/mL) and alanine aminotransferase (ALT) (≤50 U/L) levels were associated with better overall survival. Multivariate analysis identified an IP-10 level of 200 pg/mL (HR = 4.374, P = 0.045) as a predictor of overall survival.ConclusionBaseline serum IP-10 level is a predictor of survival for HCC patients undergoing Y90-RE. HBV and HCV reactivation may develop after Y90-RE treatment.Copyright © 2020 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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