- Radioembolization of Unresectable Hepatocellular Carcinoma
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Yun Hwan Joseph Kim, Sung Bum Cho, Hwan Hoon Chung
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Journal of the Korean Liver Cancer Study Group. 2010;10(1):29-34. Published online June 30, 2010
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Abstract
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- Transarterial radioembolization (TARE) using Yttrium-90 (Y-90) microspheres is emerging as a mainstream treatment
modality in the management of patients with primary and metastatic liver cancer. Yttrium-90 is a high energy beta particle
emitting radioisotope. The intellectual basis of Y-90 microsphere treatment is the preferential distribution of microspheres,
when injected in the hepatic artery, yielding much higher concentrations in the tumor compartment than the normal liver
parenchyma. The technique involves the administration of Y-90 microspheres into the hepatic artery accessed via transfemoral
route, showing almost similar procedure with transarterial chemoembolization (TACE). The Y-90 microspheres are entrapped
within the microvasculature, and release beta radiation. The high tumor to liver concentration ratio results in an effective
tumoricidal radiation absorbed dose whilst limiting the radiation injury to the normal liver. With such a therapeutic
mechanism of this method, Y-90 microspheres have been used as a treatment modality both for primary HCC and for
pre-transplant management of HCC with promising results. But preliminary evidence also suggests that the TACE and TARE
provided similar effectiveness and toxicity in patients with unresectable HCC. In conclusion, we think that prospective,
randomized controlled trials using current therapies are needed to better define optimal management of unresectable HCC.
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