Yttrium-90 ablative-selective internal radiation therapy for hepatocellular carcinoma in Chinese patients: a case series

Hepatocellular carcinoma (HCC) is the predominant primary liver malignancy worldwide. Ablative selective internal radiation therapy (A-SIRT) using yttrium-90 (90Y) radioactive microspheres has emerged as a promising treatment option for patients with HCC. This study aimed to provide comprehensive data regarding the use of A-SIRT in Chinese patients with HCC. This retrospective case series study included ten consecutive patients with HCC who were treated with 90Y A-SIRT at our institution. The clinical parameters and outcomes of the A-SIRT procedures, tumour responses (assessed using the modified Response Evaluation Criteria in Solid Tumours), subsequent treatments, and adverse events were meticulously documented. All patients were male with a median age of 66.5 years. Half had previously undergone transarterial chemoembolization, and the median tumour diameter prior to A-SIRT was 3.9 cm (2.4–11.8 cm). The median 90Y administered activity was 0.85 GBq (0.4–2.7 GBq), with median absorbed doses of 325 and 50 Gy for target tumour and normal liver, respectively. The objective response rate (ORR) was 90%, with a complete response (CR) rate of 60%. No serious adverse events were observed. The median follow-up interval from A-SIRT was 8.6 months (7.3–14.3 months), and no deaths occurred during follow-up. In this Chinese case series, A-SIRT demonstrated high efficacy (ORR, 90%; CR, 60%) and manageable side effects in patients with HCC. A-SIRT may be a promising treatment option for various stages of HCC. Yttrium-90 ablative selective internal radiation therapy was used to treat unresectable hepatocellular carcinoma confined to limited hepatic segments. This retrospective case series reports clinical outcomes and safety in ten consecutive patients. Acceptable local tumor control was achieved with a favorable hepatic safety profile. 90Y A-SIRT may be a feasible option for patients unsuitable for surgery or conventional ablation. Larger prospective studies are required to confirm these findings.