title: Yttrium-90 radioembolization for hepatocellular carcinoma: what we know and what we need to know.
abstract: In spite of substantial progress in the management of hepatocellular carcinoma (HCC), suboptimal treatment results are frequently seen in the intermediate and advanced stages of HCC. The current staging system indicates that multinodular HCC without vascular invasion needs to be treated by transarterial chemoembolization (TACE) and HCC with vascular nvasion or distant metastasis is linked to sorafenib, an an-tiangiogenic therapy. Radioembolization with yttrium-90 ((90)Y) is a recently introduced liver-directed therapy employing a catheter-based approach. Growing data suggest that (90)Y radioembolization has a potent anticancer effect with negligible adverse events if appropriate pretreatment evaluations including dosimetry, calculation of lung shunt fraction and assessment of vascular anatomy are performed. Retrospective and small prospective studies have shown response rates and survival after (90)Y therapy which are comparable to TACE and sorafenib in the intermediate and advanced stages, respectively. Although a large sample size is necessary to compare the outcome between TACE and radioembolization in intermediate-stage HCC, selected populations, for whom TACE would not be effective, are candidates for testing the role of (90)Y radioembolization. A multidisciplinary, combined approach in advanced HCC using loco-regional therapy such as radioembolization and systemic therapy including sorafenib also has to be investigated.
authors: Department of Radiology, Korea University College of Medicine, Seoul, Korea. yhkku@kumc.or.kr
authors: Yun Hwan
authors: YH
authors: Kim
authors: Do Young
authors: DY
authors: Kim
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D002404:Catheterization; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D004337:Drug Carriers; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D009536:Niacinamide / Q000031:analogs & derivatives / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use; D000077157:Sorafenib; D015996:Survival Rate; D015021:Yttrium Radioisotopes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D004337:Drug Carriers; D010671:Phenylurea Compounds; D015021:Yttrium Radioisotopes; D009536:Niacinamide; D000077157:Sorafenib