Radioembolization for the treatment of unresectable hepatocellular carcinoma: a clinical review.
Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world. The majority of patients with HCC present with unresectable disease. These patients have historically had limited treatment options secondary to HCC demonstrating chemoresistance to the currently available systemic therapies. Additionally, normal liver parenchyma has shown intolerance to tumoricidal radiation doses, limiting the use of external beam radiation. Because of these limitations, novel percutaneous liver-directed therapies have emerged. The targeted infusion of radioactive microspheres (radioembolization) represents one such therapy. Radioembolization is a minimally invasive transcatheter therapy through which radioactive microspheres are infused into the hepatic arteries that supply tumor. Once infused, these microspheres traverse the hepatic vascular plexus and selectively implant within the tumor arterioles. Embedded within the arterioles, the 90Y impregnated microspheres emit high energy and low penetrating radiation doses selectively to the tumor. Radioembolization has recently shown promise for the treatment of patients with unresectable HCC. The objective of this review article is to highlight two currently available radioembolic devices (90Y, 188Rh) and provide the reader with a recent review of the literature.
Ibrahim
Saad-M
SM
Department of Radiology, Section of Interventional Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 800, Chicago 60611, United States.
Lewandowski
Robert-J
RJ
Sato
Kent-T
KT
Gates
Vanessa-L
VL
Kulik
Laura
L
Mulcahy
Mary-F
MF
Ryu
Robert-K
RK
Omary
Reed-A
RA
Salem
Riad
R
D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000532:radiotherapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000098:blood supply / Q000532:radiotherapy*; D008863:Microspheres; D011829:Radiation Dosage; D011868:Radioisotopes / Q000008:administration & dosage; D019275:Radiopharmaceuticals / Q000008:administration & dosage* / Q000009:adverse effects; D012211:Rhenium / Q000008:administration & dosage; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage
D011868:Radioisotopes; D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes; D012211:Rhenium