Yttrium-90 Radioembolization: Current Indications and Outcomes

Background Radioembolization (RE) with 90Yttrium (Y90) has generally been used to treat patients with advanced disease. Recent data suggest, however, that RE is also safe and feasible to treat patients with early or intermediate stage disease. We herein review the current evidence regarding the use...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2023-03, Vol.27 (3), p.604-614
Main Authors: Hamad, Ahmad, Aziz, Hassan, Kamel, Ihab R., Diaz, Dayssy Alexandra, Pawlik, Timothy M.
Format: Article
Language:English
Subjects:
Ablation
Cancer therapies
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - therapy
Embolization
Embolization, Therapeutic
Gastroenterology
Gastrointestinal surgery
Humans
Liver cancer
Liver Neoplasms - pathology
Liver Neoplasms - therapy
Medical research
Medicine
Medicine & Public Health
Radiation
Response rates
Review Article
Surgery
Thoracic surgery
Transplants & implants
Treatment Outcome
Tumors
Yttrium Radioisotopes
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Summary:Background Radioembolization (RE) with 90Yttrium (Y90) has generally been used to treat patients with advanced disease. Recent data suggest, however, that RE is also safe and feasible to treat patients with early or intermediate stage disease. We herein review the current evidence regarding the use of RE with Y90 for patients with HCC. Methods A comprehensive review of the literature was performed using MEDLINE/PubMed and Web of Science databases with a search end date of August 1, 2022. Results Patients with HCC are often treated according to the BCLC staging system. Among patients with early-stage HCC (BCLC A), intermediate-stage HCC (BCLC B), and advanced-stage HCC (BCLC C), RE with Y90 has demonstrated promising results with comparable overall survival, time to disease progression, and radiological response compared with other standard of care treatment modalities. Moreover, Y90 RE can be used as a downstaging treatment modality for patients with advanced HCC who have a disease burden that is initially outside LT criteria. Radiation lobectomy (RL) has been described as a treatment modality with the intent of treating the ipsilateral liver that harbors the HCC, while also causing compensatory hypertrophy of the future liver remnant (FLR). Conclusion While initially considered as a palliative option for HCC patients, Y90 RE has emerged as an important part of the multi-modality care of patients with HCC across a wide spectrum of clinical indications.
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-022-05559-8