New treatment for hepatocellular carcinoma

Area of Science:

• Hepatobiliary Medicine
• Interventional Radiology
• Oncology

Background:

• Hepatocellular carcinoma (HCC) incidence remains high despite vaccination programs, with most patients requiring palliative care.
• Current treatments like systemic chemotherapy offer limited survival benefits.
• Locoregional therapies reduce tumor size but lack clear evidence of improved overall survival.

Purpose of the Study:

• To evaluate the efficacy of selective internal radiotherapy (SIRT) using ⁹⁰yttrium microspheres for inoperable HCC.
• To assess the potential of SIRT to facilitate surgical resection and achieve pathological remission.
• To investigate methods for reducing recurrence rates after surgical resection of HCC.

Main Methods:

• Selective internal radiotherapy (SIRT) using ⁹⁰yttrium microspheres was applied to patients with inoperable HCC.
• Tumor response was assessed using conventional radiological criteria.
• Postoperative intra-arterial administration of Lipiodol I¹³¹ was evaluated for recurrence reduction.

Main Results:

• SIRT demonstrated modest response rates but enabled surgical resection in some initially inoperable cases.
• Complete pathological remission was observed in some resected cases following SIRT.
• Hypertrophy of non-tumorous liver facilitated resection.
• Postoperative Lipiodol I¹³¹ significantly decreased recurrence rates in resected HCC patients.

Conclusions:

• Selective internal radiotherapy with ⁹⁰yttrium microspheres is a viable option for inoperable HCC, potentially converting inoperable cases to resectable ones.
• SIRT can lead to complete pathological remission in a subset of patients.
• Postoperative intra-arterial Lipiodol I¹³¹ is effective in reducing HCC recurrence after resection.