Treatment of Nonresectable Hepatocellular Carcinoma with Intrahepatic 90Y-Microspheres

摘要: Treatment for nonresectable hepatocellular carcinoma (HCC) is palliative. The relatively greater arteriolar density of hepatic tumors compared with normal liver suggests that intrahepatic arterial administration 90Y-microspheres can be selectively deposited in tumor nodules and results significantly radiation exposure to the than external irradiation. purpose this study was determine proportion (frequency) duration response, survival, toxicity after injection patients HCC. Methods: Patients documented HCC, Eastern Cooperative Oncology Group performance status 0–3, adequate bone marrow, pulmonary function were eligible study. who had significant shunting blood lungs or gastrointestinal (GI) tract could not undergo cannulation artery excluded. received a planned dose 100 Gy through catheter placed into artery. Results: Twenty-two treated 90Y-microspheres; 20 (median age, 62.5 y) evaluated treatment efficacy. Nine Okuda stage I, 11 II. median delivered 104 (range, 46–145 Gy). All 22 experienced at least 1 adverse event. Of 31 (15%) serious events, most common elevations enzymes bilirubin upper GI ulceration. response rate 20%. 127 wk; survival 54 wk. Multivariable analysis suggested >104 (P = 0.06), tumor-to-liver activity uptake ratio >2 I 0.07) associated longer survival. Conclusion: Significantly higher doses HCC by beam radiation. This appears beneficial acceptable toxicity.