Treatment options for unresectable HCC with a focus on SIRT with Yttrium ‐90 resin microspheres

Abstract Hepatocellular carcinoma (HCC), the predominant form of primary liver cancer, is the second leading cause of cancer‐related deaths across the globe. Only a small percentage of HCC patients (~20%‐30%) are diagnosed at an early stage when first‐line treatment options may be effective. The majority of HCC patients (>70%) are diagnosed with unresectable disease and given a poor overall prognosis. Current treatment guidelines recommend locoregional therapy with transarterial chemoembolisation (TACE) and systemic therapy with sorafenib as first‐line treatment for patients with intermediate and advanced stage HCC. However, multiple factors including contraindications, technical considerations and treatment‐related toxicities pose significant challenges in achieving favourable treatment outcomes, underscoring the need for a paradigm shift in managing these patients. In 2002, yttrium‐90 (Y‐90) resin microspheres was approved by the U.S. Food and Drug Administration (FDA) for the treatment of unresectable metastatic colorectal cancer to the liver with adjuvant floxuridine chemotherapy. However, thousands of patients with unresectable HCC have also been treated with resin Y‐90. For over two decades, several small‐scale prospective trials and retrospective studies have investigated and reported on the efficacy of locoregional selective internal radiation therapy (SIRT) with Y‐90 microspheres in treating unresectable HCC. Although it is currently a treatmen...
Source: International Journal of Clinical Practice - Category: Internal Medicine Authors: Tags: REVIEW ARTICLE Source Type: research