Advertisement

Journal of Gastrointestinal Cancer

, Volume 48, Issue 3, pp 276–280 | Cite as

HCC Locoregional Therapies: Yttrium-90 (Y-90) Selective Internal Radiation Therapy (SIRT)

  • İsa Burak GüneyEmail author
Review Article
  • 147 Downloads

Introduction

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and the third cause of cancer death globally with most deaths occurring within 1 year of diagnosis. HCC is the sixth most common malignancy worldwide [1, 2, 3]. Transplantation and resection remain the only potentially curative options [4]. Locoregional therapies such as chemoembolization (TACE) and radiofrequency ablation have an established palliative role in select patients [5, 6, 7, 8, 9]. Targeted molecular therapies now have a recognized role, with sorafenib demonstrating improved survival in patients with advanced HCC [10, 11].

Selective internal radiation (SIRT) treatment with Y-90 Microsphere goals are to increase the time to progression, extend overall survival, potentially downsize or downstage tumors for liver resection, ablation or transplantation, and provide palliation of symptoms. Y-90 Microsphere is a high-energy beta-emitting isotope with no primary gamma emission. The maximum...

References

  1. 1.
    Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74–108.CrossRefPubMedGoogle Scholar
  2. 2.
    Bosch FX, Ribes J, Diaz M, et al. Primary liver cancer: worldwide incidence and trends. Gastroenterology. 2004;127:S5–S16.CrossRefPubMedGoogle Scholar
  3. 3.
    El-Serag HB. Current concepts: hepatocellular carcinoma. N Engl J Med. 2011;365:1118–27.CrossRefPubMedGoogle Scholar
  4. 4.
    European Association For The Study Of The Liver, European Organisation For Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56:908–43.CrossRefGoogle Scholar
  5. 5.
    Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334:693–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Kulik LM, Atassi B, van Holsbeeck L, et al. Yttrium-90 microspheres (TheraSphere(R)) treatment of unresectable hepatocellular carcinoma: downstaging to resection, RFA and bridge to transplantation. J Surg Oncol. 2006;94:572–86.CrossRefPubMedGoogle Scholar
  7. 7.
    Lu DS, Yu NC, Raman SS, et al. Radiofrequency ablation of hepatocellular carcinoma: treatment success as defined by histologic examination of the explanted liver. Radiology. 2005;234:954–60.CrossRefPubMedGoogle Scholar
  8. 8.
    Maddala YK, Stadheim L, Andrews JC, et al. Drop-out rates of patients with hepatocellular cancer listed for liver transplantation: outcome with chemoembolization. Liver Transpl. 2004;10:449–55.CrossRefPubMedGoogle Scholar
  9. 9.
    Bruix J, Sherman M. Management of hepatocellular carcinoma. Hepatology. 2005;42:1208–36.CrossRefPubMedGoogle Scholar
  10. 10.
    Llovet JM, Real MI, Montana X, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet. 2002;359:1734–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Cheng AL, Kang YK, Chen Z, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol. 2009;10:25–34.CrossRefPubMedGoogle Scholar
  12. 12.
    Sirtex Medical. Package Insert for SIR-Spheres ® microspheres (Yttrium-90 microspheres). http://www.sirtex.com; http://sirtex.com/files/US20Package20Insert1.pdf
  13. 13.
    MDS Nordion. Package Insert for TheraSphereYttrium-90 glass microspheres. http://www.nordion.com/therasphere/physicians-packageinsert/package-insert-us.pdf
  14. 14.
    Coldwell D, Sangro B, Wasan H, Salem R, Kennedy A. General selection criteria of patients for radioembolization of liver tumors: an international working group report. Am J Clin Oncol. 2011;34:337–41. doi: 10.1097/COC.0b013e3181ec61bb.CrossRefPubMedGoogle Scholar
  15. 15.
    Kennedy A, Nag S, Salem R, Murthy R, McEwan AJ, Nutting C, et al. Recommendations for radioembolization of hepatic malignancies using yttrium-90 microsphere brachytherapy: a consensus panel report from the radioembolization brachytherapy oncology consortium. Int J Radiat Oncol Biol Phys. 2007;68:13–23. doi: 10.1016/j.ijrobp.2006.11.060.CrossRefPubMedGoogle Scholar
  16. 16.
    Sangro B, Gil-Alzugaray B, Rodriguez J, Sola I, Martinez-Cuesta A, Viudez A, et al. Liver disease induced by radioembolization of liver tumors. Cancer. 2008;112(7):1538–46.CrossRefPubMedGoogle Scholar
  17. 17.
    Delbeke D, Martin WH. Positron emission tomography in oncology. Radiol Clin N Am. 2001;39:883–917.CrossRefPubMedGoogle Scholar
  18. 18.
    Sasikumar A, Joy A, Nanabala R, Pillai MRA, Thomas B, Vikraman KR. 68Ga-PSMA PET/CT imaging in primary hepatocellular carcinoma. Eur J Nucl Med Mol Imaging. 2016;43:795–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Soydal C, Alkan A, Ozkan E, Demirkazık A, Kucuk NO. Ga-68 PSMA accumulation in hepatocellular carcinoma. Clin Oncol. 2016;1:1091.Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Nuclear Medicine Department, Faculty of MedicineÇukurova UniversityAdanaTurkey

Personalised recommendations