Older liver cancer patients respond to radioembolization as well as younger patients, study says

Rita Golfieri

Data from the multicentre ENRY evaluation of 325 patients, suggest that radioembolization may be a well tolerated and effective option for an increasing population of older patients. 

Results of an analysis by members of the multicentre European Network on Radioembolization with Yttrium-90 Resin Microspheres (ENRY), published online in late May in the Journal of Hepatology, may have important implications for older patients with inoperable primary liver cancer.

The analysis found essentially identical long-term treatment outcomes following radioembolization using SIR-Spheres in 128 elderly (aged 70 years, or older) compared to 197 younger (who were less than 70 years of age) patients with otherwise similar demographics. “Our findings suggest that age alone should not be a discriminating factor for the management of hepatocellular carcinoma patients. This is important because there is a trend towards increased age in patients diagnosed with hepatocellular carcinoma, particularly in developed countries,” said the article’s lead author, Rita Golfieri, professor of Radiology, Department of Digestive Diseases and Internal Medicine, University of Bologna, Italy.

Golfieri also stated that “While age should not be a barrier to the management of older patients with hepatocellular carcinoma, physicians should definitely take age and frailty into account when deciding which treatments to use. “For example, the relative mildness of procedure-related events after radioembolisation with SIR-Spheres compared with transcatheter arterial chemoembolization (TACE), suggests that an effective single radioembolization procedure may be more acceptable to elderly patients than the multiple courses of treatment required with TACE.

“In addition, while the tyrosine kinase inhibitor, sorafenib, represents a good treatment option for many elderly patients with hepatocellular carcinoma, the increased frequency of adverse events associated with its use in patients over 75 years old may require dose modification,” Golfieri said.

The new study is the most recent report based on an extensive evaluation of 325 hepatocellular carcinoma patients treated by teams of liver specialists, oncologists, interventional radiologists and nuclear medicine physicians at eight centres in Germany, Italy and Spain, and coordinated by Bruno Sangro, Director of the Liver Unit, Clinica Universidad de Navarra, Pamplona, Spain, and chair of the ENRY group.