Application of resin yttrium 90 microspheres in liver surgery for treatment of hepatocellular carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 Wan Yee Lau

The Chinese University of Hong Kong Medical School, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Special Administrative Region, P. R. China;

Corresponding author：

Wan Yee Lau, Email: josephlau@cuhk.edu.hk

Keywords：

yttrium 90 microspheres; hepatocellular carcinoma; selective internal radiotherapy; transarterial radioembolization

DOI：

10.7507/1007-9424.202206074

Video：

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There are six important developmental milestones for yttrium 90 microspheres in treatment of hepatocellular carcinoma (HCC). These milestones are: ① development of concepts in treatment of HCC; ② development of concepts in internal radiation therapy; ③ from basic, translational and clinical researches to clinical application; ④ internationally recognized indications for palliative treat ment of HCC; ⑤ from palliative to curative treatment of HCC after tumor downstaging with yttrium 90 microspheres using liver resection or liver transplantation; ⑥ non-surgical treatments using yttrium 90 microsphere as curative treatments. The developmental stages of yttrium 90 microsphere in treatment of HCC have undergone a very prolonged period and these stages will continue to evolve. As HCC is prevalent in China, permission of the State Food and Drug Administration to allow yttrium 90 microsphere to be clinically used on HCC patients in China will benefit a lot of patients who were not treatable by other means.

Citation： Wan Yee Lau. Application of resin yttrium 90 microspheres in liver surgery for treatment of hepatocellular carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(9): 1124-1128. doi: 10.7507/1007-9424.202206074 Copy

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3.	Ariel IM, Flynn W, Pack GT. Current possibilities of radioactive ceramic microspheres labeled with yttrium 90. Minerva Med, 1967, 58(99): 4496-4498.
4.	Burton MA, Gray BN, Klemp PF, et al. Selective internal radiation therapy: distribution of radiation in the liver. Eur J Cancer Clin Oncol, 1989, 25(10): 1487-1491.
5.	Wollner I, Knutsen C, Smith P, et al. Effects of hepatic arterial yttrium 90 glass microspheres in dogs. Cancer, 1988, 61(7): 1336-1344.
6.	Ho S, Lau WY, Leung TW, et al. Partition model for estimating radiation doses from yttrium-90 microspheres in treating hepatic tumours. Eur J Nucl Med, 1996, 23(8): 947-952.
7.	Liu DM, Leung TW, Chow PK, et al. Clinical consensus statement: Selective internal radiation therapy with yttrium 90 resin microspheres for hepatocellular carcinoma in Asia. Int J Surg, 2022, 102: 106094. doi: 10.1016/j.ijsu.2021.106094.
8.	Lau WY, Teoh YL, Win KM, et al. Current role of selective internal radiation with yttrium-90 in liver tumors. Future Oncol, 2016, 12(9): 1193-1204.
9.	Lau WY, Ho SK, Yu SC, et al. Salvage surgery following downstaging of unresectable hepatocellular carcinoma. Ann Surg, 2004, 240(2): 299-305.
10.	Kulik LM, Atassi B, van Holsbeeck L, et al. Yttrium-90 microspheres (TheraSphere) treatment of unresectable hepatocellular carcinoma: downstaging to resection, RFA and bridge to transplantation. J Surg Oncol, 2006, 94(7): 572-586.
11.	Pardo F, Sangro B, Lee RC, et al. The post-SIR-spheres surgery study (P4S): Retrospective analysis of safety following hepatic resection or transplantation in patients previously treated with selective internal radiation therapy with Yttrium-90 resin microspheres. Ann Surg Oncol, 2017, 24(9): 2465-2473.
12.	Riaz A, Gates VL, Atassi B, et al. Radiation segmentectomy: a novel approach to increase safety and efficacy of radioembolization. Int J Radiat Oncol Biol Phys, 2011, 79(1): 163-171.
13.	Gabr A, Riaz A, Johnson GE, et al. Correlation of Y90-absorbed radiation dose to pathological necrosis in hepatocellular carcinoma: confirmatory multicenter analysis in 45 explants. Eur J Nucl Med Mol Imaging, 2021, 48(2): 580-583.
14.	Cardarelli-Leite L, Chung J, Klass D, et al. Ablative transarterial radioembolization improves survival in patients with HCC and portal vein tumor thrombus. Cardiovasc Intervent Radiol, 2020, 43(3): 411-422.
15.	Chung TK, Leung TW, Chung CH, et al. ablative-transarterial radioembolization resulting in complete histopathological response of hepatocellular carcinoma in the resected liver specimen after salvage hepatectomy. Int J Surg Case Rep, 2022, 90: 106679. doi: 10.1016/j.ijscr.2021.106679.

1. Petrick JL, McGlynn KA. The changing epidemiology of primary liver cancer. Curr Epidemiol Rep, 2019, 6(2): 104-111.
2. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2018, 68(6): 394-424.
3. Ariel IM, Flynn W, Pack GT. Current possibilities of radioactive ceramic microspheres labeled with yttrium 90. Minerva Med, 1967, 58(99): 4496-4498.
4. Burton MA, Gray BN, Klemp PF, et al. Selective internal radiation therapy: distribution of radiation in the liver. Eur J Cancer Clin Oncol, 1989, 25(10): 1487-1491.
5. Wollner I, Knutsen C, Smith P, et al. Effects of hepatic arterial yttrium 90 glass microspheres in dogs. Cancer, 1988, 61(7): 1336-1344.
6. Ho S, Lau WY, Leung TW, et al. Partition model for estimating radiation doses from yttrium-90 microspheres in treating hepatic tumours. Eur J Nucl Med, 1996, 23(8): 947-952.
7. Liu DM, Leung TW, Chow PK, et al. Clinical consensus statement: Selective internal radiation therapy with yttrium 90 resin microspheres for hepatocellular carcinoma in Asia. Int J Surg, 2022, 102: 106094. doi: 10.1016/j.ijsu.2021.106094.
8. Lau WY, Teoh YL, Win KM, et al. Current role of selective internal radiation with yttrium-90 in liver tumors. Future Oncol, 2016, 12(9): 1193-1204.
9. Lau WY, Ho SK, Yu SC, et al. Salvage surgery following downstaging of unresectable hepatocellular carcinoma. Ann Surg, 2004, 240(2): 299-305.
10. Kulik LM, Atassi B, van Holsbeeck L, et al. Yttrium-90 microspheres (TheraSphere) treatment of unresectable hepatocellular carcinoma: downstaging to resection, RFA and bridge to transplantation. J Surg Oncol, 2006, 94(7): 572-586.
11. Pardo F, Sangro B, Lee RC, et al. The post-SIR-spheres surgery study (P4S): Retrospective analysis of safety following hepatic resection or transplantation in patients previously treated with selective internal radiation therapy with Yttrium-90 resin microspheres. Ann Surg Oncol, 2017, 24(9): 2465-2473.
12. Riaz A, Gates VL, Atassi B, et al. Radiation segmentectomy: a novel approach to increase safety and efficacy of radioembolization. Int J Radiat Oncol Biol Phys, 2011, 79(1): 163-171.
13. Gabr A, Riaz A, Johnson GE, et al. Correlation of Y90-absorbed radiation dose to pathological necrosis in hepatocellular carcinoma: confirmatory multicenter analysis in 45 explants. Eur J Nucl Med Mol Imaging, 2021, 48(2): 580-583.
14. Cardarelli-Leite L, Chung J, Klass D, et al. Ablative transarterial radioembolization improves survival in patients with HCC and portal vein tumor thrombus. Cardiovasc Intervent Radiol, 2020, 43(3): 411-422.
15. Chung TK, Leung TW, Chung CH, et al. ablative-transarterial radioembolization resulting in complete histopathological response of hepatocellular carcinoma in the resected liver specimen after salvage hepatectomy. Int J Surg Case Rep, 2022, 90: 106679. doi: 10.1016/j.ijscr.2021.106679.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of resin yttrium 90 microspheres in liver surgery for treatment of hepatocellular carcinoma

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