Radionuclide therapy for hepatocellular carcinoma.

AIM

Several techniques for radionuclide therapy of hepatocellular carcinoma (HCC) have been developed. In this overview the available radionuclide treatment modalities for HCC are presented, with an emphasis on Yttrium-90 (90Y) microspheres.

METHODS

We comment on the commercially available products and describe the practical aspects of these treatment modalities. Medical literature was screened for clinical data on these therapies in patients suffering from HCC. The most relevant studies are summarized, focusing on patient selection, safety and outcome.

DISCUSSION

Randomized trials are still ongoing or recently initialized. These trials will elucidate the role of 90Y-microspheres in relation to biotherapy and chemoembolization for palliative use in patients not amenable to surgery.

CONCLUSION

Large retrospective or cohort studies proof the safety of 90Y-microspheres for palliative use in HCC patients suffering Child-Pugh A or B7 cirrhosis. Future research will yield more information on its efficacy when compared to chemoembolization or sorafenib. Several groups have reported on the use of selective internal radiation therapy (SIRT) for downstaging patients to surgical curative treatment.