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  • Title: Feasibility of Boosted Radioembolization for Hepatocellular Carcinoma Larger than 5 cm.
    Author: Kim HC, Kim YJ, Lee JH, Suh KS, Chung JW.
    Journal: J Vasc Interv Radiol; 2019 Jan; 30(1):1-8. PubMed ID: 30293734.
    Abstract:
    PURPOSE: To address the feasibility of yttrium-90 (90Y) glass microspheres administered at a boosted dose in large hepatocellular carcinomas (HCCs). MATERIALS AND METHODS: From July 2016 to August 2017, 20 patients who underwent 90Y radioembolization for treatment-naïve HCC met the following inclusion criteria: (i) nodular tumor, (ii) tumor size > 5 cm, (iii) Barcelona Clinic Liver Cancer stage A/B disease, (iv) target perfused tissue dose > 150 Gy, and (v) all tumors treated in 1 session of radioembolization. Follow-up radiologic findings and clinical outcomes were retrospectively reviewed until May 2018. Tumor response was determined per modified Response Evaluation Criteria In Solid Tumors. RESULTS: Mean total radiation activity infused was 4.96 GBq ± 1.82 (median, 4.88 GBq; range, 1.63-9.15 GBq). Mean target perfused tissue dose was 263.5 Gy ± 95.2 (median, 241.6 Gy; range, 156.2-550.6 Gy). The mean number of vials used per treatment was 4.15 ± 1.4 (median, 4; range, 2-7). Complete response rates were 25% at 1 month and 60% at 3 months. Complete response of the primary index tumor was achieved in 16 patients (80%) based on best tumor response. Local progression-free survival and progression-free survival rates were 94.1% and 85.0% at 6 mo and 94.1% and 74.7% at 1 year, respectively. Four patients (20%) had symptomatic (n = 3) or asymptomatic (n = 1) benign biliary strictures. CONCLUSIONS: Radioembolization with a boosted dose in patients with large HCCs may show favorable tumor response, but with considerable biliary complications.
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