Selective internal radiation therapy using yttrium-90 resin microspheres in patients with unresectable hepatocellular carcinoma: a retrospective study

Mantry, Parvez S.; Mehta, Ashwini; Madani, Bahar; Mejía, Alejandro; Shahin, Islam

doi:10.21037/jgo.2017.08.03

Cited by 24 publications

(24 citation statements)

References 20 publications

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“…For Y-90, there was evidence that time-to-progression is at least equivalent to TACE, with improved toxicity rates with Y-90 [47,48,49]. There is currently no prospective study supporting its effects on survival.…”

Section: Overview On the Current State Of Liver Directed Therapy Smentioning

confidence: 99%

Current State of Liver-Directed Therapies and Combinatory Approaches with Systemic Therapy in Hepatocellular Carcinoma (HCC)

Viveiros

Riaz

Lewandowski

et al. 2019

Cancers

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The increasing set of liver-directed therapies (LDT) have become an integral part of hepatocellular carcinoma (HCC) treatment. These range from percutaneous ablative techniques to arterial embolization, and varied radiotherapy strategies. They are now used for local disease control, symptom palliation, and bold curative strategies. The big challenge in the face of these innovative and sometimes overlapping technologies is to identify the best opportunity of use. In real practice, many patients may take benefit from LDT used as a bridge to curative treatment such as resection and liver transplantation. Varying trans-arterial embolization strategies are used, and comparison between established and developing technologies is scarce. Also, radioembolization utilizing yttrium-90 (Y-90) for locally advanced or intermediate-stage HCC needs further evidence of clinical efficacy. There is increasing interest on LDT-led changes in tumor biology that could have implications in systemic therapy efficacy. Foremost, additional to its apoptotic and necrotic properties, LDT could warrant changes in vascular endothelial growth factor (VEGF) expression and release. However, trans-arterial chemoembolization (TACE) used alongside tyrosine-kinase inhibitor (TKI) sorafenib has had its efficacy contested. Most recently, interest in associating Y-90 and TKI has emerged. Furthermore, LDT-led differences in tumor immune microenvironment and immune cell infiltration could be an opportunity to enhance immunotherapy efficacy for HCC patients. Early attempts to coordinate LDT and immunotherapy are being made. We here review LDT techniques exposing current evidence to understand its extant reach and future applications alongside systemic therapy development for HCC.

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Section: Overview On the Current State Of Liver Directed Therapy Smentioning

confidence: 99%

Current State of Liver-Directed Therapies and Combinatory Approaches with Systemic Therapy in Hepatocellular Carcinoma (HCC)

Viveiros

Riaz

Lewandowski

et al. 2019

Cancers

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“…Salem et al reported a median survival of 20.5 months and 3-year survival of 25% in 123 patients who underwent SIRT [ 8 ]. Mantry et al reported a median survival of 13.1 months in 111 patients treated with SIRT [ 9 ]. In the ENRY study, a prospective European multicenter trial of Y-90 resin SIRT in 325 patients with unresectable HCC, the median OS was 12.8 months (95% confidence interval [CI]: 10.9–15.7) [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of selective internal radiation therapy with yttrium-90 for the treatment of unresectable hepatocellular carcinoma

Thai

Thịnh

et al. 2021

BMC Gastroenterol

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Background This retrospective analysis was undertaken to evaluate the efficiency of SIRT with Y-90 microspheres and determined prognostic factors affecting patients with unresectable HCC. Methods A total of 97 patients diagnosed with unresectable HCC who underwent SIRT with Y-90 microspheres. Patient survival was assessed using the Kaplan–Meier method, and prognostic factors affecting survival were assessed using log-rank tests and Cox proportional hazards regression. Results Among the 97 patients (90 males, mean age 60.4 ± 12.3 years) who underwent SIRT, the median clinical follow-up was 16.4 (1.8–62) months. The median overall survival (OS) was 23.9 ± 2.4 months. Tumor response according to the Modified RECIST in patients followed up beyond 6 months included a complete response (CR) to treatment in 12 patients (18.8%), partial response (PR) in 23 (35.8%), stable disease (SD) in 8 (12.5%), and progressive disease (PD) in 21 (32.8%). Factors associated with longer OS included age > 65 years, BCLC stage B, tumor size < 5 cm, tumor burden < 25%, and tumor response (CR/PR). In multivariate analysis, unilobar disease and objective tumor response (CR/PR) were predictors of longer OS. Conclusion SIRT was an effective treatment for unresectable HCC. Unilobar disease before SIRT and tumor response (CR/PR) were positive prognostic factors.

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“…At present, the internal radiation treatment of primary liver cancer mainly uses selective internal radioembolization therapy (SIRT), including 90 Y microsphere, 131 I monoclonal antibody, radioactive iodinated oil, and 125 I particle implantation. Among them, application of 90 Y microsphere radiotherapy can prolong the survival of HCC patients and can downgrade large tumors to meet the liver transplantation standards (73)(74)(75). There is evidence that SIRT can provide the survival benefit is comparable to TACE (76).…”

Section: Internal Radiotherapymentioning

confidence: 99%

Efficacy and safety of radiotherapy for primary liver cancer

Chen¹,

Chiang²,

Dawson³

2021

Chin Clin Oncol

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Primary liver cancer includes hepatocellular carcinoma (HCC, 75-85%) and intrahepatic cholangiocarcinoma (10-15%). The vast majority of patients with primary HCC are not candidates for surgical treatment. Surgical resection, liver transplantation and percutaneous puncture are effective potentially curable treatments for patients with early stage liver cancer. Radiation therapy is a non-surgical alternative treatment that has generally been used to treat patients with advanced liver cancer, although it's use in the potentially curative setting is increasing. Radiotherapy is a non-invasive local treatment which works through ionizing radiation. This review summarizes the efficacy and safety of commonly used radiotherapy methods, and reviews three-dimensional conformal radiotherapy (3DCRT), intensity modulated radiation therapy (IMRT), stereotactic body radiotherapy (SBRT), volume-modulated arc therapy (VMAT), and internal radiation therapies, for primary liver cancer (in particular for HCC).

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Selective internal radiation therapy using yttrium-90 resin microspheres in patients with unresectable hepatocellular carcinoma: a retrospective study

Abstract: Several characteristics may prove useful for selecting patients likely to respond well to Y-90 resin. These results should be confirmed in prospective studies.

Cited by 24 publications

References 20 publications

Current State of Liver-Directed Therapies and Combinatory Approaches with Systemic Therapy in Hepatocellular Carcinoma (HCC)

Current State of Liver-Directed Therapies and Combinatory Approaches with Systemic Therapy in Hepatocellular Carcinoma (HCC)

Efficacy and safety of selective internal radiation therapy with yttrium-90 for the treatment of unresectable hepatocellular carcinoma

Efficacy and safety of radiotherapy for primary liver cancer

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