{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T19:17:51Z","timestamp":1780600671530,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T00:00:00Z","timestamp":1662076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The exact place for selective internal radiation therapy (SIRT) in the therapeutic algorithm for hepatocellular carcinoma (HCC) is debated. There are limited data on its indications, efficacy, and safety in Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a multicenter retrospective cohort study of patients undergoing SIRT for HCC in all Sydney hospitals between 2005 and 2019. The primary outcome was overall survival. Secondary outcomes were progression\u2010free survival and adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 156 patients underwent SIRT across 10 institutions (mean age 67\u00a0years, 81% male). SIRT use progressively increased from 2005 (<jats:italic>n<\/jats:italic>\u00a0=\u00a02), peaking in 2017 (<jats:italic>n<\/jats:italic>\u00a0=\u00a042) before declining (2019: <jats:italic>n<\/jats:italic>\u00a0=\u00a021). Barcelona Clinic Liver Cancer stages at treatment were A (13%), B (33%), C (52%), and D (2%). Forty\u2010four (28%) patients had tumor thrombus. After a median follow\u2010up of 13.9\u00a0months, there were 117 deaths. Median overall survival was 15\u00a0months (95% confidence interval 11\u201319). Independent predictors of mortality on multivariable analysis were extent of liver involvement, Barcelona Clinic Liver Cancer stage, baseline ascites, alpha fetoprotein, and model for end\u2010stage liver disease score. Median progression\u2010free survival was 6.0\u00a0months (95% confidence interval 5.1\u20136.9\u00a0months). Following SIRT, 11% of patients were downstaged to curative therapy. SIRT\u2010related complications occurred in 17%: radioembolization\u2010induced liver disease (11%), pneumonitis (3%), gastrointestinal ulceration, and cholecystitis (1% each). Baseline ascites predicted for radioembolization\u2010induced liver disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We present the largest Australian SIRT cohort for HCC. We have identified several factors associated with a poor outcome following SIRT. Patients with early\u2010stage disease had the best survival with some being downstaged to curative therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.15986","type":"journal-article","created":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T01:04:11Z","timestamp":1661735051000},"page":"2173-2181","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Selective internal radiation therapy for hepatocellular carcinoma: A 15\u2010year multicenter Australian cohort study"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8087-0548","authenticated-orcid":false,"given":"David Stephen","family":"Prince","sequence":"first","affiliation":[{"name":"AW Morrow Gastroenterology and Liver Centre Royal Prince Alfred Hospital  Sydney New South Wales Australia"},{"name":"Department of Gastroenterology and Liver Liverpool Hospital  Sydney New South Wales 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