Abstract 157P
Background
REILD is a rare but potentially life-threatening adverse event of Y90-SIRT, with a previously reported incidence of 0-8%. To date, risk factors for REILD remain poorly defined. We aim to define risk factors for REILD in a large cohort of patients treated with Y90-SIRT for HCC from a single institution.
Methods
This is a retrospective study of consecutive patients treated with Y90 for locally advanced HCC from 2007 to 2019 at the National Cancer Centre Singapore and Singapore General Hospital. Excluded were patients lost to follow-up and those with other concomitant cancer. REILD was defined by the presence of ascites and jaundice between 4-8 weeks post-Y90-SIRT in the absence of tumor progression or bile duct obstruction. Patient demographics, clinical history, pertinent laboratory values and radiological findings were collected. Ethical approval was granted by the Institutional Review Board (IRB 2017/2541).
Results
593 patients received Y90 during the study period, of which 472 met the inclusion/exclusion criteria. 12 patients (2.54%) developed REILD. Risk factors for REILD included baseline grade 2 ALBI score (P=0.039), BCLC C HCC (P=0.003), AFP ≥400 pre-Y90 (P=0.005), and radiological ascites (P=0.003). T/N ratio and total administered Y90 dose did not correlate with REILD development. No patients demised from REILD. However, median overall survival (OS) post-Y90 was shorter for REILD patients (22.3 weeks) compared to non-REILD patients (49.1 weeks) (P=0.017). Table: 157P
Baseline characteristics | REILD | Non-REILD | P | |
N = 12 | N = 460 | |||
ALBI grade | 1 | 0 (0.00%) | 130 (28.3%) | 0.039 |
2 | 12 (100%) | 297 (64.6%) | ||
3 | 0 (0.00%) | 33 (7.17%) | ||
BCLC stage | A | 0 (0.00%) | 77 (16.7%) | 0.003 |
B | 0 (0.00%) | 171 (37.2%) | ||
C | 12 (100%) | 208 (45.2%) | ||
D | 0 (0.00%) | 4 (0.87%) | ||
AFP Pre-Y90 | <400 | 2 (20.0%) | 267 (63.9%) | 0.005 |
≥400 | 8 (80.0%) | 151 (36.1%) | ||
NA | 2 | 42 | ||
Radiological ascites | N | 9 (75.0%) | 424 (92.2%) | 0.003 |
Y | 3 (25.0%) | 36 (7.8%) | ||
T/N ratio | Mean (SD) | 3.67 (2.17) | 4.30 (4.14) | 0.369 |
Median (IQR) | 3.46 (2.15-5.37) | 3.12 (2.07-5.31) | ||
Y90 dose (Gbq) | Mean (SD) | 1.73 (1.03) | 1.70 (0.955) | 0.454 |
Median (IQR) | 1.50 (1.33-1.90) | 1.47 (0.980-2.30) |
Conclusions
Risk factors for REILD are varied and multifactorial. HCC stage and underlying liver function are major determinants of REILD risk. The risk of REILD is not dependent on factors related to Y90-SIRT delivery such as median T/N ratio and radiation dose delivered.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
CIRB.
Funding
Has not received any funding.
Disclosure
P. Chow: Financial Interests, Institutional, Advisory Role: Sirtex Medical; Financial Interests, Institutional, Speaker’s Bureau: Sirtex Medical; Financial Interests, Institutional, Research Funding: Sirtex Medical. All other authors have declared no conflicts of interest.
Resources from the same session
164P - Neoadjuvant immune checkpoints inhibitors plus chemoradiotherapy for patients with locally advanced esophageal squamous cell carcinoma
Presenter: Ming-Wei Kao
Session: Poster Display
Resources:
Abstract
165P - BMI impact on the prognosis of unresectable HCC patients receiving first-line lenvatinib or atezolizumab plus bevacizumab
Presenter: Elisabeth Amadeo
Session: Poster Display
Resources:
Abstract
166P - Preoperative risk factors strongly related to early recurrence after R0 resection of gallbladder cancer
Presenter: SANGHUN LEE
Session: Poster Display
Resources:
Abstract
167P - Peripheral blood neutrophil-to-lymphocyte ratio correlated with serum IL-8 level and predict the outcome of hepatocellular carcinoma patients treated with immune-targeted combination therapy
Presenter: Xuenan Peng
Session: Poster Display
Resources:
Abstract
168P - Real-world clinicopathological characteristics and treatment patterns of esophageal cancer patients in China
Presenter: Zhihao Lu
Session: Poster Display
Resources:
Abstract
169P - Conversion response and prognostic factors in HCC patients with macrovascular invasion treated with atezolizumab plus bevacizumab
Presenter: xiaodong Zhu
Session: Poster Display
Resources:
Abstract
170P - Atezolizumab plus bevacizumab (A+B) versus lenvatinib for BCLC-B stage of patients with hepatocellular carcinoma (HCC): A large real-life worldwide population
Presenter: Francesco Vitiello
Session: Poster Display
Resources:
Abstract
171P - Retrospective study of the correlation between proteinuria and renal function in patients (pts) with unresectable hepatocellular carcinoma (uHCC) treated with atezolizumab plus bevacizumab (Atezo+Bev): ARISE study
Presenter: Kazuomi Ueshima
Session: Poster Display
Resources:
Abstract
172P - Trastuzumab deruxtecan (T-DXd) in Chinese patients (pts) with previously treated HER2-positive locally advanced/metastatic gastric cancer (GC) or gastroesophageal junction adenocarcinoma (GEJA): Primary efficacy and safety from the phase II single-arm DESTINY-Gastric06 (DG06) trial
Presenter: Zhi Peng
Session: Poster Display
Resources:
Abstract
173P - Lenvatinib (L) versus sorafenib (S) second-line therapy in hepatocellular carcinoma (HCC) patients progressed to atezolizumab plus bevacizumab (AB)
Presenter: Mara Persano
Session: Poster Display
Resources:
Abstract