title: Transarterial radioembolization with Yttrium-90 for regional management of hepatocellular cancer: the early results of a nontransplant center.
abstract: Selective arterial radioembolization with Yttrium-90 (Y-90) microspheres has shown promise for regional management of hepatocellular cancer (HCC). Our objective was to report our early experience with this treatment modality from a nontransplant center. Treatment of patients with HCC was discussed in a multidisciplinary tumor board. Patients with unresectable disease resulting from high lesion number, ill location of the tumor, poor hepatic reserve, or medical comorbidities were offered Y-90 treatment. Liver treatment was either lobar or tumor-targeted. Response to therapy was assessed by CT scan obtained within 3 months using Response Evaluation Criteria in Solid Tumors criteria. During 2007 to 2009, 40 Y-90 radioembolizations were performed in 20 patients with age that ranged from 16 to 87 years; four patients were 80 years old or older. After the first therapy, CT assessment of the treated area showed stable disease (n=15), partial response (n=3), and progression (n=2). Of the two patients who progressed, one was retreated with a subsequent complete response. The other patient died of progressive disease. The most common side effects were mild fatigue, anorexia, and nausea. In summary, our nontransplant center experience shows that Y-90 radioembolization is a well-tolerated treatment in select patients with unresectable HCC with an associated high rate of local tumor control.
authors.affiliation: Department of Oncologic Surgery, City of Hope Comprehensive Cancer Center, Duarte, California 91010, USA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Holt
authors.forename: Lawrence D
authors.initials: LD
authors.lastname: Wagman
authors.forename: Maheswari
authors.initials: M
authors.lastname: Senthil
authors.forename: Shaun
authors.initials: S
authors.lastname: McKenzie
authors.forename: Howard
authors.initials: H
authors.lastname: Marx
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Nayana
authors.initials: N
authors.lastname: Vora
authors.forename: Joseph
authors.initials: J
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult; D015021:Yttrium Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D015021:Yttrium Radioisotopes