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Y-90 Radioembolization and PD-1 Inhibitor as Neoadjuvant Treatment in Hepatocellular Carcinoma
Published on: May 24, 2024
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[Selective internal radioembolization in nonresectable hepatocellular carcinoma]
A Bauschke1, A Altendorf-Hofmann2, M Freesmeyer3
1Klinik für Allgemein-,Visceral-und Gefäßchirurgie, Universitätsklinikum Jena, Erlanger Allee 101, 07740, Jena, Deutschland. astrid.bauschke@med.uni-jena.de.
Summary
Selective internal radioembolization (SIRT) is a feasible treatment for nonresectable hepatocellular carcinoma (HCC), offering survival benefits, especially in patients with portal vein thrombosis. Further research is needed to clarify its role in HCC management.
Area of Science:
- Hepatobiliary Surgery
- Interventional Radiology
- Nuclear Medicine
Background:
- The efficacy of selective internal radioembolization (SIRT) for hepatocellular carcinoma (HCC) remains uncertain.
- Hepatocellular carcinoma is a primary liver cancer with significant global health implications.
Purpose of the Study:
- To evaluate the role and outcomes of selective internal radioembolization (SIRT) in patients with nonresectable hepatocellular carcinoma (HCC).
- To identify prognostic factors influencing survival and time to progression in HCC patients treated with SIRT.
Main Methods:
- Retrospective analysis of 52 patients with nonresectable HCC in cirrhosis who underwent SIRT.
- SIRT was used for bridging to liver transplantation or for palliative treatment.
- Multivariate analysis was performed to identify prognostic factors.
Main Results:
- SIRT as a bridge to transplantation resulted in tumor-free status in 4 out of 5 patients post-transplant.
- For palliative treatment, 1- and 2-year survival rates were 58% and 29%, respectively.
- Negative prognostic factors included high AFP levels, short interval from diagnosis to SIRT, large tumor size, and portal vein thrombosis.
Conclusions:
- Selective internal radioembolization (SIRT) is a feasible treatment option for nonresectable HCC, comparable to transarterial chemoembolization (TACE).
- SIRT shows particular promise in patients with portal vein thrombosis, offering similar outcomes with fewer interventions and side effects.
- Alpha-fetoprotein (AFP) levels before SIRT independently influenced time to progression.
