title: Yttrium-90 radioembolization is a safe and effective treatment for unresectable hepatocellular carcinoma: a single centre experience of 45 consecutive patients.
abstract: BACKGROUND
  There is controversy regarding the role of yttrium-90 (90Y) radioembolization in the management of advanced, unresectable hepatocellular carcinoma (HCC).
  
  
  METHODS
  Forty-five consecutive patients underwent resin-based 90Y radioembolization for unresectable, HCC between 2006 and 2013 in Sydney, Australia. All patients were followed up with imaging studies at regular intervals until death. Radiologic response was evaluated with the Response Criteria in Solid Tumors (RECIST) criteria. Clinical toxicities were prospectively recorded. Survival was calculated by the Kaplan-Meier method and potential prognostic variables were identified on univariate and multivariate analysis.
  
  
  RESULTS
  Follow-up in the complete cohort was 7.8 (range, 0.1-41.8) months. The median survival after 90Y radioembolization was 27.7 months with a 36-month survival of 26%. By RECIST criteria of the 40 patients followed-up beyond 2 months, a complete response (CR) to treatment was observed in 1 patients (3%), partial response (PR) in 18 (45%), stable disease (SD) in 11 (22%) and progressive disease (PD) in 10 (25%). On multivariate analysis only radiological response to treatment was independently associated with improved survival: CR/PR to treatment vs. SD vs. PD; p < 0.001. Thirteen patients (29%) developed clinical toxicity after treatment; all complications were minor (grade I/II) and resolved without active intervention.
  
  
  CONCLUSIONS
  Radioembolization with 90Y is a safe and effective treatment for unresectable HCC.
authors.affiliation: Department of Interventional Radiology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia; UNSW Department of Surgery, St George Hospital, Kogarah, New South Wales, Australia. Electronic address: akshat16187@gmail.com.
authors.forename: Akshat
authors.initials: A
authors.lastname: Saxena
authors.affiliation: Department of Interventional Radiology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia.
authors.forename: Baerbel
authors.initials: B
authors.lastname: Meteling
authors.affiliation: UNSW Department of Surgery, St George Hospital, Kogarah, New South Wales, Australia.
authors.forename: Jada
authors.initials: J
authors.lastname: Kapoor
authors.affiliation: UNSW Department of Surgery, St George Hospital, Kogarah, New South Wales, Australia.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Golani
authors.affiliation: UNSW Faculty of Medicine, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Danta
authors.affiliation: UNSW Department of Surgery, St George Hospital, Kogarah, New South Wales, Australia.
authors.forename: David L
authors.initials: DL
authors.lastname: Morris
authors.affiliation: Department of Interventional Radiology, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia.
authors.forename: Lourens
authors.initials: L
authors.lastname: Bester
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001918:Brachytherapy; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000532:radiotherapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D015021:Yttrium Radioisotopes
keywords: HCC; Hepatocellular carcinoma; Morbidity; Radioembolization; Survival; Yttrium-90