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Yttrium-90 Radioembolization: Current Indications and Outcomes

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

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.

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Data Availability

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

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Authors and Affiliations

  1. Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA

    Ahmad Hamad & Timothy M. Pawlik

  2. Department of Surgery, University of Iowa, Iowa City, IA, USA

    Hassan Aziz

  3. Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Ihab R. Kamel

  4. Department of Radiation Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH, USA

    Dayssy Alexandra Diaz

  5. Department of Surgery, The Urban F. Meyer III and Shelley M. Meyer Chair of Cancer Research, Columbus, OH, USA

    Timothy M. Pawlik

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Hamad, A., Aziz, H., Kamel, I.R. et al. Yttrium-90 Radioembolization: Current Indications and Outcomes. J Gastrointest Surg 27, 604–614 (2023). https://doi.org/10.1007/s11605-022-05559-8

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