Underlying liver disease influences volumetric changes in the spared hemiliver after selective internal radiation therapy with 90Y in patients with hepatocellular carcinoma.
OBJECTIVE
Hypertrophy of the contralateral liver lobe after treatment with yttrium-90 ((90)Y) microspheres has recently been reported. This study aimed to quantify left hepatic lobe hypertrophy after right-sided radioembolization for hepatocellular carcinoma (HCC) and to identify pretreatment predictive factors of hypertrophy in an Asian population.


METHODS
A retrospective review of patients with inoperable HCC undergoing selective internal radiation treatment (SIRT) with (90)Y microspheres at a single institution from January 2008 to January 2012 was performed. Only patients who had treatment delivered via the right hepatic artery alone were included.


RESULTS
In all, 17 patients fulfilling the study criteria were identified. The mean percentage of left-lobe hypertrophy was 34.2% ± 34.9% (range 19.0-106.5%) during a median of 5-month follow-up. Patients with hepatitis B were found to experience a significantly greater degree of hypertrophy than those with hepatitis C or alcoholic liver cirrhosis. There were no cases of acute liver failure after the administration of SIRT in this study and none of the patients developed disease in the contralateral lobe over the study period.


CONCLUSIONS
Administration of unilobar SIRT to the right liver lobe in patients with HCC resulted in a significant degree of contralateral left lobe hypertrophy. Patients with hepatitis B experienced a greater degree of hypertrophy than those with hepatitis C or alcoholic liver cirrhosis.
Department of General Surgery, Singapore General Hospital, Singapore.
Jin Yao
JY
Teo
Brian Kim Poh
BK
Goh
Foong Koon
FK
Cheah
John Carson
JC
Allen
Richard Hoau Gong
RH
Lo
David Chee Eng
DC
Ng
Anthony Soon Whatt
AS
Goh
Andrew Yu Keat
AY
Khor
Hui Shan
HS
Sim
Jia Jun
JJ
Ng
Pierce Kah-Hoe
PK
Chow
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy* / Q000821:virology; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D006984:Hypertrophy / Q000209:etiology / Q000821:virology; D008099:Liver / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000821:virology; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015021:Yttrium Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*
D015021:Yttrium Radioisotopes
hepatitis B; hepatocellular carcinoma; hypertrophy; liver cirrhosis; selective internal radiation therapy