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Review
. 2024 Dec 1;13(6):974-990.
doi: 10.21037/hbsn-23-504. Epub 2024 Jun 6.

Selective internal radiation therapy across Barcelona Clinic Liver Cancer (BCLC) stages of hepatocellular carcinoma: literature review

Paul Vigneron #  1   2   3 , Maria Stella Franzè #  2   3   4 , Julia Chalaye  5 , Vania Tacher  2   3   6 , Anna Sessa  1   2   3 , Alain Luciani  2   3   6 , Hicham Kobeiter  2   3   6 , Hélène Regnault  1   3 , Ancuta Bejan  1 , Julien Calderaro  2   3   7 , Rami Rhaiem  3   8   9 , Daniele Sommacale  2   3   10 , Giovanni Raimondo  4 , Vincent Leroy  1   2   3 , Raffaele Brustia  2   3   10 , Giuliana Amaddeo  1   2   3
Affiliations
Review

Selective internal radiation therapy across Barcelona Clinic Liver Cancer (BCLC) stages of hepatocellular carcinoma: literature review

Paul Vigneron et al. Hepatobiliary Surg Nutr. .

Abstract

Background and objective: Selective internal radiation therapy (SIRT) represents an endovascular treatment option for patients with hepatocellular carcinoma (HCC). Its use is widely recognized in the intermediate and advanced HCC, but it has become more prevalent in recent years in different Barcelona Clinic Liver Cancer (BCLC) stages. The aim of this review is to summarize the role of SIRT and its clinical implications through different stages of HCC.

Methods: A literature review of papers on this topic was performed using PubMed MEDLINE, focusing exclusively on the role of yttrium-90 SIRT across all BCLC stages and comparing it with other treatments. Only English-language papers currently available until September 2023 were considered.

Key content and findings: Many studies have shown that SIRT is a promising tool with multiple uses, such as tumour control in the context of bridge-to-liver transplantation or resection, tumour downstaging, and curative therapy in selected patients. Therefore, according to the recent update of BCLC staging system criteria, SIRT now emerges as a potential curative treatment for early-stage HCC patients, serving as an alternative when ablation or resection is not feasible. It is also a promising treatment compared to transarterial chemoembolization (TACE) as well as in combination with immunotherapies.

Conclusions: SIRT is a safe and effective treatment for selected patients at all BCLC stages of HCC. Therefore, due to its numerous advantages, SIRT may prove useful in many complex HCC treatment situations in the near future.

Keywords: Hepatocellular carcinoma (HCC); radioembolization; yttrium-90 (90Y); selective internal radiation therapy (SIRT); transarterial radioembolization (TARE).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-23-504/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Role of SIRT across BCLC stages of HCC. BCLC, Barcelona Clinic Liver Cancer; SIRT, selective internal radiation therapy; HCC, hepatocellular carcinoma.
See this image and copyright information in PMC

References

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