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Case Reports
. 2015 Dec 22;7(12):e425.
doi: 10.7759/cureus.425.

Dramatic Response of a Large, 10 Cm Hepatocellular Carcinoma to Monotherapy with Yttrium-90 Based Selective Internal Radiation Therapy

Tejan Diwanji  1 , Tuo Dong  2 , Fred Moeslein  3 , Michael Chuong  1
Affiliations
Case Reports

Dramatic Response of a Large, 10 Cm Hepatocellular Carcinoma to Monotherapy with Yttrium-90 Based Selective Internal Radiation Therapy

Tejan Diwanji et al. Cureus. .

Abstract

Hepatocellular carcinoma (HCC) is predominantly diagnosed in advanced stages and not amenable to surgical resection and transplantation. Systemic therapies have had a limited efficacy in treating HCC. Although HCC is a radiosensitive tumor, treatments with external-beam radiation are limited by radiosensitivity of normal liver tissue and surrounding organs-at-risk, i.e. bowel, stomach, and kidney. Several large retrospective series have demonstrated a modest effect of selective internal radiation therapy (SIRT) with Yttrium-90 ((90)Y) microspheres in unresectable HCC, both in terms of tumor response and survival. The authors present a patient with an extremely large, multifocal, unresectable HCC who achieved a dramatic response with SIRT treatment.

Keywords: hepatocellular carcinoma; radioactive embolization; sirt; tumor embolization.

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Conflict of interest statement

One of the authors, Dr. Fred Moeslein, is a proctor for Sirtex. He has no other affiliations with Sirtex and no other financial ties.

Figures

Figure 1
Figure 1. Representative axial slice from pre-treatment MRI
Figure 2
Figure 2. Representative coronal slice from pre-treatment MRI
Figure 3
Figure 3. Representative axial slice from MRI obtained after first SIRT procedure
Figure 4
Figure 4. Representative coronal slice from MRI obtained after first SIRT procedure
Figure 5
Figure 5. Representative axial slice from CT obtained three months after second SIRT procedure
Figure 6
Figure 6. Representative coronal slice from CT obtained three months after second SIRT procedure
Figure 7
Figure 7. Representative axial slice from CT obtained six months after second SIRT procedure
Figure 8
Figure 8. Representative coronal slice from CT obtained six months after second SIRT procedure
Figure 9
Figure 9. Representative axial slice from CT obtained nine months after second SIRT procedure
Figure 10
Figure 10. Representative coronal slice from CT obtained nine months after second SIRT procedure
See this image and copyright information in PMC

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