157P - T/N ratio and radiation dose delivered do not correlate with the development of Radioembolization-Induced Liver Disease (REILD) in Hepatocellular Carcinoma (HCC) following Y90 selective internal radiation therapy (Y90-SIRT): A retrospective, single tertiary centre cohort study

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

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.