Due to the small numbers within subgroups, no further prognostic factors were explored for TTP. Survival was determined selleck chemicals llc from the day of first Y-90 treatment. Figure 3 shows the Kaplan-Meier estimator with a median survival rate for the entire sample of 16.4 months (95% CI 12.1-inf. months). The corresponding survival probability at 6 months was 75% (95% CI 66%-85%), whereas it was 59% (95% CI 47%-75%) 1 year after treatment initiation. Significant differences were observed with respect to the survival times of patients with
Child A liver cirrhosis as compared to patients with Child B (Fig. 4A, P = 0.013). Although the estimated median survival rate in the Child A group was 17.2 months (95% CI 12.1-∞ months), the median survival rate in patients with Child B was only 6 months (95% CI 4.2-∞ months). Accordingly, the 6-month survival probability for Child A patients is 79% (95% CI 70%-90%) as compared to 16% (95% CI 23%-92%) for Child B patients. Another important element
that determines prognosis in patients with advanced HCC is the presence of macrovascular invasion. Figure 4B shows the difference in survival between patients with (31%) and without (69%) PVT. Survival probability in the PVT group at 6 months was 65% (95% CI 46%-92%) with a median survival rate of 10.0 months (95% CI 6.0-∞ months). In contrast, patients without detectable PVT had a survival probability Selumetinib of 76% (95% CI 65%-88%) and a median survival of 16.4 months (95% CI 12.1-∞ months). When the tumor stage was used to stratify survival (Fig. 4C), we observed that patients with BCLC stage B had a median survival rate of 16.4 months (95% CI 12.1-∞ months). For patients with stage C no median survival rate was assessable, as the last estimate of survival probability Liothyronine Sodium in this group was 51% (95% CI 33%-81%). The corresponding survival probabilities at 6 months were 75% (95% CI 63%-89%) and 72% (95% CI 57%-87%), respectively. The most commonly reported clinical AE was a transient fatigue syndrome with a maximum between day 3 and
7 posttherapy in 61% of patients and a vague abdominal pain reported by 56% of patients. A single case with radiation cholecystitis was the only relevant gastrointestinal AE; the patient was treated by cholecystemtomy 10 days after Y-90 microsphere application. No patient experienced treatment-induced ulcerations in stomach or duodenum. In addition, we detected no patients with radiation-induced pneumonitis or other grade 3/4 AEs related to the lungs. One patient showed dissection of the proper hepatic artery during treatment, resulting in a functional stenosis of the vessel. Due to preexisting collaterals by way of the gastroduodenal artery, this dissection remained without clinical consequences. All bilirubin elevations that were observed within the observation period were considered treatment-related hepatotoxicity.