***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose To prospect ively compare SIRT and DEB-TACE for treating hepatocellular carcinoma ( HCC ) . Methods From 04/2010–07/2012 , 24 patients with histologically proven unresectable N0 , M0 HCCs were r and omized 1:1 to receive SIRT or DEB-TACE . SIRT could be repeated once in case of recurrence ; while , TACE was repeated every 6 weeks until no viable tumor tissue was detected by MRI or contraindications prohibited further treatment . Patients were followed-up by MRI every 3 months ; the final evaluation was 05/2013 . Results Both groups were comparable in demographics ( SIRT : 8males/4females , mean age 72 ± 7 years ; TACE : 10males/2females , mean age 71 ± 9 years ) , initial tumor load ( 1 patient ≥25 % in each group ) , and BCLC ( Barcelona Clinic Liver Cancer ) stage ( SIRT : 12 × B ; TACE  1 × A , 11 × B ) . Median progression-free survival ( PFS ) was 180 days for SIRT versus 216 days for TACE patients ( p = 0.6193 ) with a median TTP of 371 days versus 336 days , respectively ( p = 0.5764 ) . Median OS was 592 days for SIRT versus 788 days for TACE patients ( p = 0.9271 ) . Seven patients died in each group . Causes of death were liver failure ( n = 4 SIRT group ) , tumor progression ( n = 4 TACE  group ) , cardiovascular events , and inconclusive ( n = 1 in each group ) . Conclusions No significant differences were found in median PFS , OS , and TTP . The lower rate of tumor progression in the SIRT group was nullified by a greater incidence of liver failure . This pilot study is the first prospect i ve r and omized trial comparing SIRT and TACE for treating HCC , and results can be used for sample size calculations of future studies UNLABELLED Yttrium-90 radioembolization ( Y90RE ) is a novel approach to radiation therapy for hepatocellular carcinoma ( HCC ) , never tested in phase 2 studies . Fifty-two patients with intermediate ( n.17 ) to advanced ( n.35 ) HCC were prospect ively recruited to assess , as the primary endpoint , efficacy of Y90RE on time-to-progression ( TTP ) . Secondary endpoints were tumor response , safety , and overall survival ( OS ) .  All patients were Eastern Cooperative Oncology Group ( ECOG ) score 0 - 1 , Child-Pugh class A-B7 .  Y90RE treatments aim ed at a lobar delivery of 120 Gy . Retrospective dosimetric correlations were conducted and related to response . Fifty-eight treatments were performed on 52 patients . The median follow-up was 36 months . The median TTP was 11 months with no significant difference between portal vein thrombosis ( PVT ) versus no PVT ( 7 versus 13 months ) . The median OS was 15 months ( 95 % confidence interval [ CI ] , 12 - 18 months ) with a nonsignificant trend in favor of non-PVT versus PVT patients ( 18 versus 13 months ) . Five complete responses occurred ( 9.6 % ) , and the 2 year-progression rate was 62 % . Objective response was 40.4 % , whereas the disease control rate ( 78.8 % ) significantly affected survival ( responders versus nonresponders : 18.4 % versus 9.1 % ; P = 0.009 ) . Tumor response significantly correlated with absorbed dose in target lesions ( r = 0.60 , 95 % CI , 0.41 - 0.74 , P < 0.001 ) and a threshold of 500 Gy predicted response ( area under the curve , 0.78 ) . Mortality at 30 - 90 days was 0%-3.8 % . Various grade s of reduction in liver function occurred within 6 months in 36.5 % of patients , with no differences among stages . On multivariate analysis , tumor response was the sole variable affecting TTP ( P < 0.001 ) and the second affecting survival ( after Child-Pugh class ) . CONCLUSION Y90RE is an effective treatment in intermediate to advanced HCC , particularly in the case of PVT . Further prospect i ve evaluations comparing Y90RE with conventional treatments are warranted INTRODUCTION For patients with resectable hepatocellular carcinoma ( HCC ) , hepatectomy remains one of the best treatment options to provide long-term survival . However , more than 50 % of the patients have unresectable disease upon diagnosis even though there are no distant metastases . Transarterial chemoembolization ( TACE ) is a well-established treatment option that offers a palliative survival benefit for this group of patients . A better treatment for unresectable HCC has been sought after . There is some evidence that transarterial radioembolization ( TARE ) with the agent yttrium-90 produces encouraging outcomes , especially in patients with portal vein tumor thrombus . This study aims to analyze the outcomes of TARE at our center . METHODS From August 2009 to April 2013 , 16 patients underwent TARE at our center . Sixteen patients with similar tumor characteristics were selected to undergo TACE alone for comparison . A retrospective analysis of the prospect ively collected data of the patients was conducted . Only patients with newly diagnosed primary tumors were included in this study . RESULTS The median survival for patients having TARE was 19.9 versus 14.0 months in the TACE group ( P=0.615 ) . There was no difference in terms of tumor response according to the modified Response Evaluation Criteria in Solid Tumors ( mRECIST ) ( P=0.632 ) . The 1- , 2- and 3-year survival rates in the TARE group were 80.0 % , 30.5 % and 20.3 % respectively . The 1-year survival in the TACE group was 58.3 % ( P=0.615 ) . For patients who had major vascular invasion ( eight in each group ) , the 1- and 2-year survival rates in the TARE group were 62.5 % and 15.6 % respectively , while the 1-year survival in the TACE group was 35.0 % ( P=0.664 ) . CONCLUSIONS The two groups showed similar results in terms of tumor response and overall survival benefit . TARE might provide a survival benefit for patients with major vessel invasion BACKGROUND & AIMS Quality of life ( QoL ) is an important aspect of any palliative treatment . However , few data are available from studies comparing how embolotherapy affects QoL for patients with hepatocellular carcinoma ( HCC ) . We performed a health-related QoL study in patients with HCC treated by transarterial chemoembolization ( TACE ) or (90)Y radioembolization .  METHODS We performed a prospect i ve study of patients undergoing (90)Y radioembolization ( n = 29 ) or TACE ( n = 27 ) for HCC . We assessed patients before treatment and 2 and 4 weeks after treatment using the Functional Assessment of Cancer Therapy-Hepatobiliary ( FACT-Hep ) survey . We compared differences in health-related QoL between the treatment groups using linear regression repeated- measures analysis . RESULTS At baseline , the groups had comparable baseline Child-Pugh class and performance statuses , although patients undergoing TACE had lower tumor burdens ( P = .018 ) and less-advanced disease , based on United Network for Organ Sharing and Barcelona stage ( P = .03 and P = .02 , respectively ) , permitting injections at segmental arteries ( P < .0001 ) . There were no significant differences between groups in overall FACT-Hep health-related QoL scores ( P = .055 , effect size [ ES ] , .54 ) , owing to a limited sample size . Despite the more advanced disease of patients who received (90)Y radioembolization , they had a significantly better QoL , based on social well being ( P = .019 ; ES , .65 ) , functional well-being ( P = .031 ; ES , .60 ) , and embolotherapy-specific scores ( P = .018 ; ES , .67 ) . They also had a trend toward better overall QoL ( P = .055 ; ES , .54 ) and higher Trial Outcome Index ( P = .05 ; ES , .56 ) and FACT-Hep scores ( P = .071 ; ES , .52 ) . CONCLUSIONS In a prospect i ve study , although (90)Y radioembolization was used to treat patients with more advanced disease , those who received this treatment had significant increases in several features of QoL , whereas patients who received TACE had decreases in QoL scores . However , because of the limited sample size , there was no significant difference in overall FACT-Hep health-related QoL scores . The increase was greatest in the embolotherapy-specific score . Clinical Trials.gov , number NCT00739167 Unresectable hepatocellular carcinoma is extremely difficult to treat . TheraSphere consists of yttrium-90 ( a pure beta emitter ) microspheres , which are injected into the hepatic arteries . This article review s the safety and survival of patients with hepatocellular carcinoma who were treated with yttrium-90 microspheres . Eighty patients were selected from a data base of 108 yttrium-90 microsphere-treated patients and were staged by using Child-Pugh , Okuda , and Cancer of the Liver Italian Program scoring systems . Patients were treated with local , regional , and whole-liver approaches . Survival from first treatment was analyzed with Kaplan-Meier and Cox regression methods . Adverse events and complications of treatment were coded by using the Southwest Oncology Group toxicity scoring system . Patients received liver doses ranging from 47 to 270 Gy . Thirty-two patients ( 40 % ) received more than 1 treatment . Survival correlated with pretreatment Cancer of the Liver Italian Program scores ( P = .002 ) , as well as with the individual Cancer of the Liver Italian Program components , Child-Pugh class , alpha-fetoprotein levels , and percentage of tumor replacement . Patients classified as Okuda stage I ( n = 54 ) and II ( n = 26 ) had median survival duration s and 1-year survival rates of 628 days and 63 % , and 384 days and 51 % , respectively ( P = .02 ) . One patient died of liver failure judged as possibly related to treatment . Thus , in selected patients with hepatocellular carcinoma , yttrium-90 microsphere treatment is safe and well tolerated . On the basis of these results , a r and omized controlled trial is warranted comparing yttrium-90 microsphere treatment with transarterial chemoembolization by using the Cancer of the Liver Italian Program system for prospect i ve stratified r and omization BACKGROUND & AIMS Chemoembolization is one of several st and ards of care treatment for hepatocellular carcinoma ( HCC ) . Radioembolization with Yttrium-90 microspheres is a novel , transarterial approach to radiation therapy . We performed a comparative effectiveness analysis of these therapies in patients with HCC . METHODS We collected data from 463 patients who were treated with transarterial locoregional therapies ( chemoembolization or radioembolization ) over a 9-year period . We excluded patients who were not appropriate for comparison and analyzed data from 245 ( 122 who received chemoembolization and 123 who received radioembolization ) . Patients were followed for signs of toxicity ; all underwent imaging analysis at baseline and follow-up time points . Overall survival was the primary outcome measure . Secondary outcomes included safety , response rate , and time-to-progression . Uni- and multivariate analyses were performed . RESULTS Abdominal pain and increased transaminase activity were more frequent following chemoembolization ( P < .05 ) . There was a trend that patients treated with radioembolization had a higher response rate than with chemoembolization ( 49 % vs 36 % , respectively , P = .104 ) . Although time-to-progression was longer following radioembolization than chemoembolization ( 13.3 months vs 8.4 months , respectively , P = .046 ) , median survival times were not statistically different ( 20.5 months vs 17.4 months , respectively , P = .232 ) . Among patients with intermediate-stage disease , survival was similar between groups that received chemoembolization ( 17.5 months ) and radioembolization ( 17.2 months , P = .42 ) . CONCLUSIONS Patients with HCC treated by chemoembolization or radioembolization with Yttrium-90 microspheres had similar survival times .  Radioembolization result ed in longer time-to-progression and less toxicity than chemoembolization . Post hoc analyses of sample size indicated that a r and omized study with > 1000 patients would be required to establish equivalence of survival times between patients treated with these two therapies INTRODUCTION This study compares radioembolization ( (90)Y ) versus doxorubicin drug eluting beads ( DEBDOX ) in the treatment of unresectable hepatocellular carcinoma with portal vein thrombosis . METHODS Using our prospect ively maintained , multi-center , non-controlled intra-arterial therapy registry , we identified 28 
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Conclusions TARE ( 90Y ) increased 2-year OS rates in the observational subgroup and result ed in better OR rates , according to mRECIST criteria , in comparison with cTACE .
Furthermore , a lower risk of AEs was observed for TARE ( 90Y ) than for cTACE