Radioembolization in Hepatocellular Carcinoma |
Ho Jong Chun |
Department of Radiology, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea |
Correspondence:
Ho Jong Chun, Email: chunray@catholic.ac.kr |
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Abstract |
Radioembolization is an emerging treatment modality in patients with hepatocellular
carcinoma (HCC) and is a form of brachytherapy in which intra-arterially injected Ytrrium-90
microspheres are used for internal radiation purpose. Ytrrium-90 is a high energy beta
particle-emitting radioisotope. Ytrrium-90 microspheres administered via arterial route direct
the highly concentrated radiation to the tumor while normal liver parenchyma is relatively
spared due to its preferential blood supply from portal venous blood. Main complications
do not result from the microembolic effect, even in patients with portal vein thrombosis,
but rather from an excessive irradiation to the non-target tissues including the liver. All
the evidence that support the use of radioembolization in HCC is based on retrospective
series or non-controlled prospective studies. However, reliable data can be obtained from
the literature, particularly since the recent publication of large series. When compared to
the standard of treatment for the intermediate and advanced stages (TACE and sorafenib),
radioembolization consistently provides similar survival rates. Many randomized controlled
trials using radioembolization are underway and will provide optimal evidences as standard
treatment for unresectable HCC. |
Key Words:
Hepatocellular carcinoma; Radioembolization |
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