Yttrium-90 microspheres for the treatment of hepatocellular carcinoma
Section snippets
Patients selected
Data from 80 patients were included in the analysis. The centers providing data were The Toronto General Hospital (n = 17), the University of Pittsburgh Medical Center Starzl Transplant Institute (n = 51), the Hospital of the University of Pennsylvania (n = 7), and Johns Hopkins University Hospital (n = 5). Patients were treated under 2 fixed-dose protocols. The Toronto Protocol, using a nominal fixed dose of 100 Gy, began enrolling patients in March 1992 and ended enrollment in March 1996.18
Study population
The study population is characterized in Table 1, Table 2, Table 3, Table 4. The population was predominantly older, white, and male, and 35 patients (44%) had bilobar disease. Fifty-six (70%) patients had documented cirrhosis, 10 (13%) had ascites, and 13 (16%) had >50% of their liver replaced by tumor. The serum bilirubin level was increased in 13 (16%) patients, and 72 (90%) were characterized as having Child-Pugh class A liver disease. HCC staging resulted in 54 (68%) patients being
Discussion
Most patients diagnosed with unresectable HCC succumb to liver failure as a result of advancing cirrhosis or tumor progression.29 Because tumor burden in the liver is a major threat to patient survival and well-being and because systemic chemotherapy is ineffective, local liver-directed therapies have been developed to reduce tumor burden, providing palliation and the potential for increased survival. Decreasing tumor burden unintentionally results in compromised liver function through
References (48)
Surgical management of hepatocellular carcinomaresection and ablation
J Vasc Interv Radiol
(2002)- et al.
Role of liver transplantation in the management of hepatocellular carcinoma
J Vasc Interv Radiol
(2002) - et al.
Trends in survival of patients with hepatocellular carcinoma between 1977 and 1996 in the United States
Hepatology
(2001) - et al.
Thermal ablation therapy for hepatocellular carcinoma
J Vasc Interv Radiol
(2002) - et al.
Chemoembolization of hepatocellular carcinoma
J Vasc Interv Radiol
(2002) - et al.
Determinants of postembolization syndrome after hepatic chemoembolization
J Vasc Interv Radiol
(2001) - et al.
The treatment of hepatic metastases from colorectal cancer with radiation therapy alone or combined with chemotherapy or misonidazole
Cancer Treat Rev
(1989) - et al.
Analysis of radiation-induced liver disease using the Lyman NTCP model
Int J Radiat Oncol Biol Phys
(2002) - et al.
Long-term results of hepatic artery fluorodeoxyuridine and conformal radiation therapy for primary hepatobiliary cancers
Int J Radial Oncol Biol Phys
(1997) - et al.
Yttrium-90 microspheresradiation therapy for unresectable liver cancer
J Vasc Interv Radiol
(2002)
Use of yttrium-90 glass microspheres (TheraSphere®) for the treatment of unresectable hepatocellular carcinoma (HCC) in patients with portal vein thrombosis
J Vasc Interv Radiol
Chemoembolization of hepatocellular carcinoma—what to tell the skepticsreview and meta-analysis
Tech Vasc Interv Radiol
Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma
Hepatology
Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinomaa randomised controlled trial
Lancet
Prospective randomized trial of chemoembolization versus intra-arterial injection of 131I-labeled-iodized oil in the treatment of hepatocellular carcinoma
Hepatology
AHPBA/AJCC consensus conference on staging of hepatocellular carcinomaconsensus statement
HPB
Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver
J Hepatol
Rising incidence of hepatocellular carcinoma in the United States
N Engl J Med
A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma
N Engl J Med
Radiation hepatitis
Am J Roentgenol Radium Ther Nucl Med
Pathogenesis of veno-occlusive liver disease after radiation
Arch Pathol Lab Med
Human radiation hepatitis
Arch Pathol
Treatment of intrahepatic cancers with radiation doses based on a normal tissue complication probability model
J Clin Oncol
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Supported in part by MDS Nordion, Ottawa, Ontario, Canada.