title: Yttrium-90 Selective Internal Radiation Therapy with Glass Microspheres for Hepatocellular Carcinoma: Current and Updated Literature Review.
abstract: Hepatocellular carcinoma is the most common primary liver cancer and it represents the majority of cancer-related deaths in the world. More than 70% of patients present at an advanced stage, beyond potentially curative options. Ytrrium-90 selective internal radiation therapy (Y90-SIRT) with glass microspheres is rapidly gaining acceptance as a potential therapy for intermediate and advanced stage primary hepatocellular carcinoma and liver metastases. The technique involves delivery of Y90 infused glass microspheres via the hepatic arterial blood flow to the appropriate tumor. The liver tumor receives a highly concentrated radiation dose while sparing the healthy liver parenchyma due to its preferential blood supply from portal venous blood. There are two commercially available devices: TheraSphere® and SIR-Spheres®. Although, Y90-SIRT with glass microspheres improves median survival in patients with intermediate and advanced hepatocellular carcinoma and has the potential to downstage hepatocellular carcinoma so that the selected candidates meet the transplantable criteria, it has not gained widespread acceptance due to the lack of large randomized controlled trials. Currently, there are various clinical trials investigating the use of Y90-SIRT with glass microspheres for treatment of hepatocellular carcinoma and the outcomes of these trials may result in the incorporation of Y90-SIRT with glass microspheres into the treatment guidelines as a standard therapy option for patients with intermediate and advanced stage hepatocellular carcinoma.
authors.affiliation: Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
authors.forename: Edward Wolfgang
authors.initials: EW
authors.lastname: Lee
authors.affiliation: Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Alanis
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
authors.forename: Sung-Ki
authors.initials: SK
authors.lastname: Cho
authors.affiliation: Division of Hepatology, Department of Medicine, Pfleger Liver Institute, University of California at Los Angeles, Los Angeles, CA 90024, USA.
authors.forename: Sammy
authors.initials: S
authors.lastname: Saab
mesh_terms: D001918:Brachytherapy; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D004337:Drug Carriers / Q000009:adverse effects / Q000737:chemistry* / Q000378:metabolism; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D008863:Microspheres; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use; D015021:Yttrium Radioisotopes / Q000737:chemistry
chemical_list: D004337:Drug Carriers; D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes
keywords: Hepatocellular carcinoma; Radioembolization; Selective internal radiation therapy; Yttrium 90