Yttrium-90 glass microsphere radioembolization as frontline treatment for hepatocellular carcinoma with localized portal vein invasion

Question What is the optimal radioembolization approach and its outcome for hepatocellular carcinoma with localized portal vein invasion (Vp1-3) in patients with preserved liver function? Findings A tumor absorbed dose exceeding 600 Gy via a tandem approach achieved complete response rates above 80% and median overall survival longer than 49.5 months. Clinical relevance Ablative radioembolization, delivering a tumor absorbed dose exceeding 600 Gy via a tandem approach, should be considered for hepatocellular carcinoma with localized portal vein tumor thrombosis (Vp1-3) in patients with preserved liver function and no extrahepatic spread.