History and evolution of Yttrium-90 radioembolization for hepatocellular carcinoma

Aman Saini, Alex Wallace, Sadeer Alzubaidi, M. Grace Knuttinen, Sailendra Naidu, Rahul Sheth, Hassan Albadawi, Rahmi Oklu

Research output: Contribution to journalReview articlepeer-review

Abstract

Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer and affects millions worldwide. Due to the lack of effective systemic therapies for HCC, researchers have been investigating the use of locoregional tumor control with Yttrium-90 (Y90) radioembolization since the 1960s. Following the development of glass and resin Y90 microspheres in the early 1990s, Y90 radioembolization has been shown to be a safe and efficacious treatment for patients with HCC across Barcelona Clinic Liver Cancer (BCLC) stages. By demonstrating durable local control, good long term outcomes, and equivalent if not superior tumor responses and tolerability when compared to alternative therapies including transarterial chemoembolization (TACE) and sorafenib, Y90 radioembolization is being increasingly used in HCC treatment. More recently, investigations into variations in Y90 radioembolization technique including radiation segmentectomy and radiation lobectomy have further expanded its clinical utility. Here, we discuss the history and evolution of Y90 use in HCC. We outline key clinical trials that have established the safety and efficacy of Y90 radioembolization, and also summarize trials comparing its efficacy to existing HCC treatments. We conclude by reviewing the techniques of radiation segmentectomy and lobectomy, and by discussing dosimetry.

Original languageEnglish (US)
Article number55
JournalJournal of Clinical Medicine
Volume8
Issue number1
DOIs
StatePublished - Jan 2019

Keywords

  • HCC
  • Hepatocellular carcinoma
  • Liver cancer
  • Radioembolization
  • Y90
  • Yttrium-90

ASJC Scopus subject areas

  • Medicine(all)

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