Yttrium 90 microspheres for the treatment of hepatocellular carcinoma

Khairuddin Memon, Robert J. Lewandowski, Ahsun Riaz, Riad Salem*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter

18 Scopus citations

Abstract

Yttrium-90 microspheres are radioactive particles which are increasingly being employed for treating patients with unresectable hepatocellular carcinoma (HCC). The procedure is called radioembolization. It involves the injection of micron-sized embolic particles loaded with a radioisotope by use of transarterial techniques. Because of the sensitivity of liver parenchyma and relative insensitivity of tumor, external radiation has played a limited role in treating HCC. 90Y administered via arterial route directs the highly concentrated radiation to the tumor while healthy liver parenchyma is relatively spared due to its preferential blood supply from portal venous blood. This technique has proven useful for the majority of patients with HCC as most of them present in advanced stage, beyond potentially curative options (resection/liver transplantation). 90Y microspheres can be used in downstaging large tumors to bring within transplantable criteria, in patients with portal venous thrombosis due to tumor invasion and as palliative therapy. There are two available devices for 90Y administration; TheraSphere® (glass based) and SIR-Spheres® (resin based). The procedure is performed on an outpatient basis. The incidence of complications is comparatively less and may include nausea, fatigue, abdominal pain, hepatic dysfunction, biliary injury, fibrosis, radiation pneumonitis, GI ulcers, and vascular injury; however, these can be avoided by meticulous pretreatment assessment, careful patient selection, and adequate dosimetry. This article explores the technical and clinical aspects of 90Y radioembolization with keeping emphasis on patient selection, uses, and complications.

Original languageEnglish (US)
Title of host publicationMultidisciplinary Treatment of Hepatocellular Carcinoma
EditorsJean-Nicolas Vauthey, Antoine Brouquet
Pages207-224
Number of pages18
DOIs
StatePublished - Jan 1 2013

Publication series

NameRecent Results in Cancer Research
Volume190
ISSN (Print)0080-0015

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Memon, K., Lewandowski, R. J., Riaz, A., & Salem, R. (2013). Yttrium 90 microspheres for the treatment of hepatocellular carcinoma. In J-N. Vauthey, & A. Brouquet (Eds.), Multidisciplinary Treatment of Hepatocellular Carcinoma (pp. 207-224). (Recent Results in Cancer Research; Vol. 190). https://doi.org/10.1007/978-3-642-16037-0_14