Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013 Dec;58(6):2188-97.
doi: 10.1002/hep.26382. Epub 2013 Oct 4.

Yttrium 90 radioembolization for the treatment of hepatocellular carcinoma: biological lessons, current challenges, and clinical perspectives

Riad Salem  1 , Vincenzo Mazzaferro, Bruno Sangro
Affiliations
Review

Yttrium 90 radioembolization for the treatment of hepatocellular carcinoma: biological lessons, current challenges, and clinical perspectives

Riad Salem et al. Hepatology. 2013 Dec.
No abstract available

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: RS and VM are advisors to Nordion. RS and BS are advisors to Sirtex Medical.

Figures

Figure 1
Figure 1. Right lobe radiohepatectomy demonstrating simultaneous Y90 treatment to the HCC, lobar atrophy and regeneration/hypertrophy of the remnant liver after one single session of Y90
This is a 70 year old male with HCV-related cirrhosis and good liver function (Child-Pugh A6, MELD 8) who presented with 2 right lobe HCCs (11 cm, 3 cm) associated with segmental portal vein invasion and AFP serum level of 3412 UI/mL. A) Baseline CT Scan. The right hepatic lobe volume (segments 5-6-7-8) was 1325 cm3 while the remnant left lobe (segments 1-2-3-4) had a calculated volume of 434 cm3. B) Six months after Y90 there is no evidence of active tumor, AFP is 14.3 UI/mL and near complete atrophy of the right lobe. The right lobe volume is now 152 cm3 while the left has hypertrophied to 1202 cm3. The patient was considered for resection but eventually maintained on strict imaging follow-up. He is recurrence-free 2 years after Y-90 radioembolization.
Figure 2
Figure 2. Salvage transplantation after Y90 downstaging
This is a 58 y.o. patient with good performance status, Child B7 cirrhosis who received Y90 for a large infiltrating HCC with satellites and non-neoplastic portal vein thrombosis (i.e. beyond the up-to-7 and UCSF criteria, BCLC C). After 3 months, while there was near total tumor response with post-radiation right liver lobe atrophy and dense fibrosis, progressive deterioration of liver function occurred. The patient underwent liver transplantation because of tumor-unrelated Child-stage migration. The patient alive and well (no recurrence) 2 years after transplantation (30 months after Y90).
See this image and copyright information in PMC

References

    1. Parkin DM, B F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74–108. - PubMed
    1. Salem R, Lewandowski RJ, Kulik L, Wang E, Riaz A, Ryu RK, Sato KT, et al. Radioembolization Results in Longer Time-to-Progression and Reduced Toxicity Compared With Chemoembolization in Patients With Hepatocellular Carcinoma. Gastroenterology. 2011;140:497–507 e492. - PMC - PubMed
    1. Salem R, Lewandowski RJ, Mulcahy MF, Riaz A, Ryu RK, Ibrahim S, Atassi B, et al. Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres: a comprehensive report of long-term outcomes. Gastroenterology. 2010;138:52–64. - PubMed
    1. Lewandowski RJ, Kulik LM, Riaz A, Senthilnathan S, Mulcahy MF, Ryu RK, Ibrahim SM, et al. A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant. 2009;9:1920–1928. - PubMed
    1. Riaz A, Miller FH, Kulik LM, Nikolaidis P, Yaghmai V, Lewandowski RJ, Mulcahy MF, et al. Imaging response in the primary index lesion and clinical outcomes following transarterial locoregional therapy for hepatocellular carcinoma. JAMA. 2010;303:1062–1069. - PMC - PubMed

Publication types

Substances