Incidence and risk factors for sustained hepatic function toxicity 6 months after radioembolization: analysis of the radiation-emitting sir-spheres in non-resectable liver tumor (RESIN) registry

• Published in: Journal of gastrointestinal oncology 2021-04, Vol.12 (2), p.639-657
• Main Authors: Brown, Daniel, Krebs, Henry, Brower, Jayson, O'Hara, Ryan, Wang, Eric, Vaheesan, Kirubahara, Du, Liping, Matsuoka, Lea, D'Souza, Donna, Sze, Daniel Y, Golzarian, Jafar, Gandhi, Ripal, Kennedy, Andrew
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2078-6891; 2219-679X
• DOI: 10.21037/jgo-20-346

To quantify rates and risk factors for toxicity after hepatic radioembolization using resin yttrium-90 microspheres. Radiation-Emitting SIR-Spheres in Non-resectable liver tumor (RESIN) registry enrollees were reviewed with 614 patients included. Mean patient age was 63.1±12.5 years. The majority of patients were male (n=375, 61%) and white (n=490, 80%). Common tumor types were hepatocellular (n=197, 32%), colorectal (n=187, 30%) and neuroendocrine (n=56, 9%). Hepatotoxicity was measured using the Common Terminology Criteria for Adverse Events (CTCAE v 5). Potential risk factors for hepatotoxicity were tested using the Kruskal-Wallis or Pearson Chi-squared tests, and multivariate linear regressions. At 6 months, 115 patients (18.7%) died (n=91, 14.8%), entered hospice (n=20, 3.3%) or sought treatment elsewhere (n=4, 4%). Seven (1.1%) deaths were from liver decompensation. Grade 3 toxicity rates were: bilirubin (n=85, 13.8%), albumin (n=28, 4.6%), ALT (n=26, 4.2%) and AST (n=37, 6.0%). For each of these liver function test components, baseline abnormal labs predicted Grade 3 toxicity at follow-up by Kruskal-Wallis test (P