| Role of Yttrium-90 Radioembolization in the Management of Hepatocellular Carcinoma |
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Do Young Kim |
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Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea |
Correspondence:
Do Young Kim,
Email: dyk1025@yuhs.ac
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Copyright ©2015 by The Korean Liver Cancer Association |
| Abstract |
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Yttrium-90 radioembolization has emerged as a novel therapy for hepatocellular carcinoma
(HCC) of intermediate or advanced stage. Yttrium-90 has characteristics of short half-life and
tissue penetration depth. Potent anti-cancer effect by this isotope enables to kill the tumor
for 6 months after administration. Although transarterial chemoembolization (TACE) is the
standard modality for multinodular HCC without vascular invasion, big size or numerous nodules
does not allow enough treatment effect of TACE. Post-embolization syndrome resulting
poor quality of life, liver dysfunction and hepatic arterial damage are other pitfalls of TACE.
In several studies, radioembolization showed survival comparable to TACE, shorter hospital
stay and less treatment sessions. In advanced HCC with portal vein invasion, radioembolization
demonstrated similar or better survival compared with sorafenib. The atrophy of lobe
treated by radioembolization and hypertrophy in the contralateral lobe can be called radiation
lobectomy, which makes it possible to perform a following curative therapy. The role of
radioembolization in unresectable HCC in terms of downstaging or bridge to transplantation
needs to be further studied. Radioembolization is contraindicated in HCC patients with main
portal vein occlusion and with poor liver function. The International guidelines for HCC have
some limitations and thus rooms for radioembolization to be incorporated. |
| Key Words:
Hepatocellular carcinoma; Radioembolization; Yttrium-90 |
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