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Results in Hepatocellular Carcinoma

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Liver Radioembolization with 90Y Microspheres

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

In the last years, new locoregional and systemic therapies have been developed for the management of hepatocellular carcinoma. Among the novel therapeutic procedures, yttrium-90 radioembolization has produced encouraging results across the whole spectrum of HCC, from early to advanced stages. All the evidence that support the use of radioembolization in HCC is based on retrospective series or non-controlled prospective studies, However, reliable data can be obtained from the literature, particularly since the recent publication of large series accounting for nearly 700 patients. Radioembolization achieves intense tumor response in targeted lesions and produces average disease control rates above 80 %. This effect supports its use for the treatment of early tumors with a curative intent, as a bridge to liver transplantation, and for unresectable HCC who exceed the transplant criteria or are not suitable for liver resection, with a downstaging intention. When compared to the standard of care for the intermediate and advanced stages (transarterial embolization and sorafenib), radioembolization consistently provides similar survival rates. It can be considered as a treatment option for those patients who are not considered good candidates for or have failed to transarterial embolization. It can also be a true alternative to sorafenib for the treatment of advanced tumors without extrahepatic metastases. The toxicity profile of radioembolization is favorable. Rarely, complications may result from irradiation of nontarget tissues including the liver and liver toxicity is the most challenging adverse event in HCC patients arising in a cirrhotic liver.

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Authors and Affiliations

  1. Liver Unit, Clinica Universidad de Navarra, Avda. Pio XII 36, 31008, Pamplona, Spain

    Mercedes Iñarrairaegui & Bruno Sangro

  2. Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBEREHD), Pamplona, Spain

    Mercedes Iñarrairaegui & Bruno Sangro

Authors
  1. Mercedes Iñarrairaegui
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  2. Bruno Sangro
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Correspondence to Mercedes Iñarrairaegui .

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Editors and Affiliations

  1. Departamento de Radiología, Clínica Universidad de Navarra, Pamplona, Spain

    José Ignacio Bilbao

  2. Institut für Klinische Radiologie, Universitätsklinikum München Klinikum Großhadern, München, Germany

    Maximilian F Reiser

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Iñarrairaegui, M., Sangro, B. (2013). Results in Hepatocellular Carcinoma. In: Bilbao, J., Reiser, M. (eds) Liver Radioembolization with 90Y Microspheres. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2013_920

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  • DOI: https://doi.org/10.1007/174_2013_920

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  • Print ISBN: 978-3-642-36472-3

  • Online ISBN: 978-3-642-36473-0

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