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Title: SIRT Compared with DEB-TACE for Hepatocellular Carcinoma: a Real-world Study (the SITAR Study).
Austin Authors: Hirsch, Ryan D;Mills, Chris;Sawhney, Rohit;Sood, Siddharth ;Bird, Virginia;Mishra, Gauri;Dev, Anouk;Kemp, William;Lubel, John;Roberts, Stuart K;Gow, Paul J ;Nicoll, Amanda J
Affiliation: Gastroenterology and Hepatology
Gastroenterology, Eastern Health, 3W Box Hill Hospital, Box Hill, VIC, 3128, Australia
Gastroenterology and Hepatology, Melbourne Health, Parkville, Victoria, Australia
Gastroenterology, Monash Health, Clayton, Victoria, Australia
Gastroenterology, Alfred Health, Melbourne, Victoria, Australia
Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
Central Clinical School, Monash University, Melbourne, Victoria, Australia
Issue Date: Sep-2021
Publication information: Journal of Gastrointestinal Cancer 2021; 52(3): 907-914
Abstract: Hepatocellular carcinoma (HCC) is responsible for 1% of deaths worldwide, and the incidence continues to increase. Despite surveillance programs, 70% of HCC patients are not suitable for curative options at diagnosis, and therefore, non-curative treatments are essential to modern clinical practice. There are many novel treatments, though their roles are not well defined. This study aimed to contrast Selective Internal Radiation Therapy (SIRT) and Drug Eluting Bead Transarterial Chemoembolisation (DEB-TACE) to further define their roles. This was a retrospective multicentre cohort study. Factors included for analysis were type of HCC treatment, number of lesions, lesion size, multiple disease severity scores, cirrhosis and vascular invasion. The primary endpoint was transplant-free survival. Transplant-free survival was similar between the two cohorts (p = 0.654), despite a variation in median lesion size, SIRT: 54.5 mm, DEB-TACE: 34 mm (p ≤ 0.001). A univariate Cox proportional hazard model utilising treatment modality as the covariate showed no significant difference in survival (DEB-TACE HR 1.4 (95%CI 0.85-2.15 p = 0.207). The size of the largest lesion was the best predictor of 3-year survival (p = 0.035). Lesion size was inversely associated with survival (HR 1.01 (95%CI 1-1.02, p = 0.025)) on multivariate analysis. This study is the first to catalogue the experience of using SIRT in HCC in a real-world Australian population. It has demonstrated no difference in survival outcomes between DEB-TACE and SIRT. Further, it has shown SIRT to be a reasonable alternative to DEB-TACE especially in larger lesions and has demonstrated that DEB-TACE has a role in select patients with advanced disease.
DOI: 10.1007/s12029-020-00502-z
ORCID: 0000-0003-1283-470X
Journal: Journal of Gastrointestinal Cancer
PubMed URL: 32901445
PubMed URL:
Type: Journal Article
Subjects: Drug eluting bead chemoembolisation
Hepatocellular carcinoma
Intra-arterial therapy
Liver cancer
Selective internal radiation therapy
Transarterial radiation therapy
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