Radioembolization With Yttrium-90 Resin Microspheres in Hepatocellular Carcinoma: A Multicenter Prospective Study.
OBJECTIVE
The aim of this prospective study was to reveal the efficacy and safety of Yttrium-90 (Y) radioembolization in Korean patients with hepatocellular carcinoma (HCC).


METHODS
A total of 40 HCC patients were prospectively recruited from 7 centers. The response to treatment was assessed on the basis of the modified Response Evaluation Criteria in Solid Tumors criteria. The time to progression and overall survival were also evaluated, and the assessment of safety was done according to National Cancer Institute Common Terminology Criteria, Version 3.0.


RESULTS
Forty-two treatments of Y radioembolization were carried out. Median follow-up was 29 months. At 3 months, the complete response, partial response (PR), and stable disease were seen in 4 (10.0%), 19 (47.5%), and 15 (37.5%) patients, respectively. The response rate was 57.5% (23/40), and disease control rate was 95% (38/40) at 3 months. The response rate at 6 months was 63.9% (23/36), and disease control rate was 83.3% (30/36). The median time to progression was 18 months. During follow-up, 10 HCC-related deaths occurred and the 3-year survival rate was 75%. In 19 patients with Barcelona Clinic Liver Cancer-B stage, the 3-year survival rate was 50%. The tumor number (>5) was the only significant predictor associated with survival. The most common adverse event was abdominal pain of mild to moderate degree, and all the complications were manageable. Twenty-six (65%) patients underwent other treatments such as transarterial chemoembolization because of local progression or remnant viable lesion.


CONCLUSIONS
Y radioembolization might be a safe and effective treatment modality in intermediate-stage to advanced-stage HCC.
Departments of *Internal Medicine ††Radiology, Yonsei University College of Medicine, Seoul Departments of †Radiology ‡Internal Medicine §Nuclear Medicine, Korea University College of Medicine, Seoul Departments of ∥Internal Medicine ¶Radiology, Catholic University College of Medicine Departments of #Internal Medicine **Radiology, Ulsan University College of Medicine, Ulsan Departments of ‡‡Internal Medicine §§Radiology, Seoul National University College of Medicine, Seoul Departments of ∥∥Radiology ¶¶Internal Medicine, Pusan National University College of Medicine, Pusan Departments of ##Radiology ***Internal Medicine, Chonnam National University College of Medicine, Chonnam, Korea.
Do Young
DY
Kim
Beom Jin
BJ
Park
Yun Hwan
YH
Kim
Kwang-Hyub
KH
Han
Sung Bum
SB
Cho
Kyu Ran
KR
Cho
Sun-Ho
SH
Uhm
Jae-Gol
JG
Choe
Jong Young
JY
Choi
Ho Jong
HJ
Chun
Han Chu
HC
Lee
Dong Il
DI
Gwon
Kwang Hun
KH
Lee
Jung-Hwan
JH
Yoon
Jin Wook
JW
Chung
Chang Won
CW
Kim
Jeong
J
Heo
Jae Kyu
JK
Kim
Young Eun
YE
Joo
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011446:Prospective Studies; D056910:Republic of Korea; D015996:Survival Rate; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
D015021:Yttrium Radioisotopes