Transarterial radioembolization for hepatocellular carcinoma:An update and perspectives  

作　　者：Rodolfo Sacco Valeria Mismas Sara Marceglia Antonio Romano Luca Giacomelli Marco Bertini Graziana Federici Salvatore Metrangolo Giuseppe Parisi Emanuele Tumino Giampaolo Bresci Ambra Corti Manuel Tredici Michele Piccinno Luigi Giorgi Carlo Bartolozzi Irene Bargellini 

机构地区：[1]Department of Gastroenterology,Pisa University Hospital [2]Department of Electronics,Information technology and Bioengineering,Engineering School of Milan [3]Department of Nuclear Medicine,Pisa University Hospital [4]Division of Health Physics,Pisa University Hospital [5]Department of Radiology,Pisa University Hospital

出　　处：《World Journal of Gastroenterology》2015年第21期6518-6525,共8页世界胃肠病学杂志（英文版）

摘　　要：In the last decade trans-arterial radioembolization has given promising results in the treatment of patients with intermediate or advanced stage hepatocellular carcinoma(HCC),both in terms of disease control and tolerability profile.This technique consists of the selective intra-arterial administration of microspheres loaded with a radioactive compound(usually Yttrium90),and exerts its therapeutic effect through the radiation carried by these microspheres.A careful and meticulous selection of patients is crucial before performing the radioembolization to correctly perform the procedure and reduce the incidence of complications.Radioembolization is a technically complex and expensive technique,which has only recently entered clinical practice and is supported by scant results from phase Ⅲ clinical trials.Nevertheless,it may represent a valid alternative to transarterial chemoembolization(TACE) in the treatment of intermediate-stage HCC patients,as shown by a comparative retrospective assessment that reported a longer time to progression,but not of overall survival,and a more favorable safety profile for radioembolization.In addition,this treatment has reported a higher percentage of tumor shrinkage,if compared to TACE,for pre-transplant downsizing and it represents a promising therapeutic option in patients with large extent of disease and insufficient residual liver volume who are not immediately eligible for surgery.Radioembolization might also be a suitable companion to sorafenib in advanced HCC or it can be used as a potential alternative to this treatment in patients who are not responding or do not tolerate sorafenib.In the last decade trans-arterial radioembolization has given promising results in the treatment of patients with intermediate or advanced stage hepatocellular carcinoma(HCC),both in terms of disease control and tolerability profile.This technique consists of the selective intra-arterial administration of microspheres loaded with a radioactive compound(usually Yttrium90),and exerts its therapeutic effect through the radiation carried by these microspheres.A careful and meticulous selection of patients is crucial before performing the radioembolization to correctly perform the procedure and reduce the incidence of complications.Radioembolization is a technically complex and expensive technique,which has only recently entered clinical practice and is supported by scant results from phase Ⅲ clinical trials.Nevertheless,it may represent a valid alternative to transarterial chemoembolization(TACE) in the treatment of intermediate-stage HCC patients,as shown by a comparative retrospective assessment that reported a longer time to progression,but not of overall survival,and a more favorable safety profile for radioembolization.In addition,this treatment has reported a higher percentage of tumor shrinkage,if compared to TACE,for pre-transplant downsizing and it represents a promising therapeutic option in patients with large extent of disease and insufficient residual liver volume who are not immediately eligible for surgery.Radioembolization might also be a suitable companion to sorafenib in advanced HCC or it can be used as a potential alternative to this treatment in patients who are not responding or do not tolerate sorafenib.

关 键 词：Hepatocellular carcinoma RADIOEMBOLIZATION Transarterial CHEMOEMBOLIZATION SORAFENIB STAGING RECIST  Modified RECIST DOWNSIZING Clinical trial 

分 类 号：R735.7[医药卫生—肿瘤]