Selective internal radiation therapy with yttrium-90 resin microspheres followed by anatomical hepatectomy: A potential curative strategy in advanced hepatocellular carcinoma.

Autor: Feng X; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Zhang L; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Niu H; Hainan Cancer Hospital, Haikou, China., Zhang H; The Southwest Hospital of Army Medical University, Chongqing, China., Yang L; Hainan Bo'ao Super Hospital, Qionghai, China., Wen Y; Hainan Bo'ao Super Hospital, Qionghai, China., Chen SY; Department of Radiology, Banner University Medical Center-Phoenix, University of Arizona College of Medicine, Phoenix, Arizona, USA., Shi Y; The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital, Chengdu, China., He Z; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Yu L; Hainan Cancer Hospital, Haikou, China., Wang Y; Hainan Cancer Hospital, Haikou, China., Huang X; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Wang Z; Hainan Cancer Hospital, Haikou, China., Qin M; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Wen X; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Zhang Z; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Song J; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Zheng Z; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Yin H; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Zhang H; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Ma L; Hainan Bo'ao Super Hospital, Qionghai, China., Wei J; Hainan Bo'ao Super Hospital, Qionghai, China., Wu X; Hainan Cancer Hospital, Haikou, China., Zhang L; The Southwest Hospital of Army Medical University, Chongqing, China., Zhao Y; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Lu Q; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Xiao H; Hainan Bo'ao Super Hospital, Qionghai, China., Liu T; Hainan Bo'ao Super Hospital, Qionghai, China., Fang P; Hainan Bo'ao Super Hospital, Qionghai, China., Wei L; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China., Gandhi RT; Department of Interventional Radiology, Florida International University Herbert Wertheim College of Medicine, Miami, Florida, USA., Dong J; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Jazyk: angličtina
Zdroj: Asia-Pacific journal of clinical oncology [Asia Pac J Clin Oncol] 2024 Apr; Vol. 20 (2), pp. 319-322. Date of Electronic Publication: 2023 Jan 19.
DOI: 10.1111/ajco.13900
Abstrakt: About 80% of hepatocellular carcinoma (HCC) patients are in advanced stages and ineligible for curative surgery. Palliative treatments just maintained limited survival, thus an effective downstaging therapy is badly needed. Here we report an initially unresectable patient who underwent radical hepatectomy after successful downstaging with selective internal radiation therapy (SIRT). A 34-year-old man was diagnosed with China Liver Cancer Staging (CNLC) IIIa HCC. Due to insufficient future liver remnant and vascular involvement, the patient was suggested to be unresectable. SIRT with yttrium-90 resin microspheres was given. At three months post-SIRT, a complete response was achieved. The tumor was downstaged to CNLC Ia stage. The patient underwent anatomical hepatectomy 5 months after SIRT. Histopathological examination of the resected specimen showed 4% viable tumor cells inside a necrotic mass. To our knowledge, this is the first case who underwent SIRT with yttrium-90 resin microspheres in China mainland. The success of the downstaging in this case renders a possible cure to be achieved in an initially unresectable patient. In addition, the nearly complete tumor necrosis in the resected specimen indicates a good prognosis post-surgery. This is the first case who underwent SIRT with yttrium-90 resin microspheres in China mainland. SIRT followed by anatomical hepatectomy is a potentially curative strategy for unresectable HCC, which deserves a confirmative trial in the future.
(© 2023 John Wiley & Sons Australia, Ltd.)
Databáze: MEDLINE
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