title: A systematic review on the safety and effectiveness of yttrium-90 radioembolization for hepatocellular carcinoma with portal vein tumor thrombosis.
abstract: OBJECTIVE
  Over the past two decades, several advances have been made in the management of patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT). Yttrium-90 ( 90 Y) radioembolization has recently been made a treatment option for patients with HCC and PVTT. However, there is still a need to systematicly evaluate the outcomes of 90 Y radioembolization for HCC and PVTT. We aimed to assess the safety and effectiveness of 90 Y radioembolization for HCC and PVTT. We performed a systematic review of clinical trials, clinical studies, and abstracts from conferences that qualified for analysis.
  
  
  METHODS
  PubMed, EMBASE, Cochrane Database of Systematic Review, CINAHL, and the "gray" literature (Google Scholar) were searched for all reports (1991-2016) related to 90 Y radioembolization for HCC and PVTT.
  
  
  RESULTS
  A total of 14 clinical studies and three abstracts from conferences including 722 patients qualified for the analysis. The median length of follow-up was 7.2 months; the median time to progression was 5.6 months, and median disease control rate was 74.3%. Radiological response data were reported in five studies, and the median reported value of patients with complete response, partial response, stable disease, and progressive disease were 3.2%, 16.5%, 31.3%, and 28%, respectively. The median survival was 9.7 months for all patients, including the median overall survival (OS) were 12.1, 6.1 months of Child-Pugh class A and B patients, and the median OS were 6.1, 13.4 months of main and branch PVTT patients, respectively. The common toxicities were fatigue, nausea/vomiting, abdominal pain, mostly not requiring medical intervention needed no medication intervention.
  
  
  CONCLUSIONS
  90 Y radioembolization is a safe and effective treatment for HCC and PVTT.
authors.affiliation: Department of Interventional Radiology, Changzhou No. 2 People's Hospital, Nanjing Medical University, Changzhou, 213003, Jiangsu Province, China.
authors.forename: Zhongzhi
authors.initials: Z
authors.lastname: Jia
authors.affiliation: Department of Interventional Radiology, Changzhou No. 2 People's Hospital, Nanjing Medical University, Changzhou, 213003, Jiangsu Province, China.
authors.forename: Guomin
authors.initials: G
authors.lastname: Jiang
authors.affiliation: Department of Interventional Radiology, Changzhou No. 2 People's Hospital, Nanjing Medical University, Changzhou, 213003, Jiangsu Province, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Tian
authors.affiliation: Department of General Surgery, Changzhou No. 2 People's Hospital, Nanjing Medical University, Changzhou, 213003, Jiangsu Province, China.
authors.forename: Chunfu
authors.initials: C
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, Changzhou No. 2 People's Hospital, Nanjing Medical University, Changzhou, 213003, Jiangsu Province, China.
authors.forename: Xihu
authors.initials: X
authors.lastname: Qin
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D002986:Clinical Trials as Topic; D018450:Disease Progression; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D011169:Portal Vein / Q000473:pathology*; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000628:therapy*; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes