ALBI Score Is a Strong Predictor of Toxicity Following SIRT for Hepatocellular Carcinoma
Céline Lescure, Florian Estrade, Maud Pedrono, Boris Campillo‐Gimenez, Samuel Le Sourd, Marc Pracht, Xavier Palard, Héloïse Bourien, Léa Muzellec, Thomas Uguen, Yan Rolland, Étienne Garin, Julien Edeline
Abstract
Background: Selective internal radiation therapy (SIRT) is an innovative treatment of hepatocellular carcinoma (HCC). The albumin-bilirubin (ALBI) score was designed to better evaluate liver functions in HCC. Methods: We studied, retrospectively, data from patients treated with SIRT for HCC. The primary endpoint was the occurrence of radioembolization-induced liver disease (REILD). The secondary endpoint was overall survival (OS). Results: 222 patients were studied. The ALBI grade 1 patients had significantly less REILD (3.4%) after the first SIRT than ALBI grade 2 or 3 patients (16.8%, p = 0.002). Of the 207 patients with data, 77 (37.2%) had a worsening of ALBI grade after one SIRT. The baseline ALBI grade was significantly associated with OS (p = 0.001), also in the multivariable analysis. The ALBI grade after the first SIRT was significantly associated with OS (p ≤ 0.001), with median OS of 26.4 months (CI 95% 18.2–34.7) for ALBI grade 1 patients (n = 48) versus 17.3 months (CI 95% 12.9–21.8) for ALBI grade 2 patients (n = 123) and 8.1 months (CI 95% 4.1–12.1) for ALBI grade 3 patients (n = 36). Conclusions: The baseline ALBI grade is a strong predictor of REILD. The baseline ALBI score and variations of ALBI are prognostic after SIRT.