CardioVascular and Interventional Radiology

, Volume 41, Issue 3, pp 459–465 | Cite as

Safety and Efficacy of Transarterial Radioembolization Combined with Chemoembolization for Bilobar Hepatocellular Carcinoma: A Single-Center Retrospective Study

  • Joon Ho Kwon
  • Gyoung Min KimEmail author
  • Kichang Han
  • Jong Yun Won
  • Man Deuk Kim
  • Do Yun Lee
  • Junhyung Lee
  • Woosun Choi
  • Yong Seek Kim
  • Do Young Kim
  • Kwang-Hyub Han
Clinical Investigation



Radioembolization induced liver disease (REILD) is a possible sequela of transarterial radioembolization (TARE), particularly in cases of whole-liver treatment. To mitigate this problem, the safety and efficacy of combined transarterial chemoembolization (TACE) and TARE were evaluated for patients with bilobar hepatocellular carcinoma (HCC).

Materials and Methods

Nineteen patients (mean age 60 years; range 27–82 years) treated for HCC between June 2012 and September 2014 were included in the analysis. Each patient was treated with combined TARE and TACE for bilobar HCC, with or without portal vein thrombosis. The hepatic lobe with large HCC was treated with TARE, and the other lobe with small HCC(s) was treated with TACE. Laboratory and clinical data were investigated to determine REILD occurrence. Survival data were analyzed to compare the treatment efficacy of alternative treatment modalities, including TACE and sequential TARE.


All patients underwent TARE for a dominant tumor in one lobe and TACE for small nodule(s) in the other lobe of the liver. The mean yttrium-90 microspheres used in TARE were 2.8 GBq (range; 1.0-3.5 GBq), and the mean doses of doxorubicin and iodized oil were 24.5 mg and 5.2 mL, respectively, for TACE. No statistical differences were noted between laboratory data measured before and after treatment, and no procedure-related major clinical complications occurred. The median time-to-progression of patients was 10.0 months, and the median overall survival was 27.3 months.


Combined radioembolization and chemoembolization appears to be a safe and effective treatment modality for bilobar HCC.


Hepatocellular carcinoma Transarterial radioembolization Transarterial chemoembolization Radioembolization induced liver disease Barcelona clinic liver cancer (BCLC) 


Compliance with Ethical Standards

Conflict of interest

The authors have no conflicts to report.

Ethical Approval

For this type of study formal consent is not required.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  • Joon Ho Kwon
    • 1
  • Gyoung Min Kim
    • 1
    • 3
    Email author
  • Kichang Han
    • 1
  • Jong Yun Won
    • 1
  • Man Deuk Kim
    • 1
  • Do Yun Lee
    • 1
  • Junhyung Lee
    • 1
  • Woosun Choi
    • 1
  • Yong Seek Kim
    • 1
  • Do Young Kim
    • 2
  • Kwang-Hyub Han
    • 2
  1. 1.Department of RadiologyYonsei University College of MedicineSeoulRepublic of Korea
  2. 2.Department of Internal Medicine, Institution of GastroenterologyYonsei University College of MedicineSeoulRepublic of Korea
  3. 3.Department of Radiology, Severance Hospital, Research Institute of Radiological ScienceYonsei University College of MedicineSeoulRepublic of Korea

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