Treatment of Inoperable Hepatocellular Carcinoma With Intrahepatic Arterial yttrium-90 Microspheres: A Phase I and II Study

Br J Cancer. 1994 Nov;70(5):994-9. doi: 10.1038/bjc.1994.436.

Abstract

Eighteen patients with inoperable hepatocellular carcinoma (HCC) were treated with intrahepatic arterial yttrium-90 microspheres. All these patients showed a lung shunting below 15% and a tumour-to-normal ratio higher than 2 as determined by diagnostic technetium-99m macroaggregated albumin (Tc-MAA) gamma scintigraphy. The treatment was given through an arterial port placed during laparotomy. The radiation doses to the liver and tumour were determined intraoperatively with a beta probe and liquid scintillation counting of multiple liver biopsies. The treatment was well tolerated without major complications. In all patients the tumour marker fell to a level which ranged from 41% to 0.2% of the pretreatment level. Tumour regression was found to be dose related. Progressive or static disease occurred in a higher proportion of patients whose tumours received < 120 Gy (P = 0.005). Survival was better in those whose tumours received > 120 Gy (median survival = 55.9 weeks) than those whose tumours received lower doses (median survival = 26.2 weeks). This difference is statistically significant with P = 0.005. We conclude that yttrium-90 microsphere therapy is safe and that tumour response is dose related. A tumour dose of > 120 Gy is recommended.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase I
  • Clinical Trial, Phase II

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biomarkers, Tumor / blood
  • Carcinoma, Hepatocellular / radiotherapy*
  • Carcinoma, Hepatocellular / surgery
  • Dose-Response Relationship, Drug
  • Female
  • Hepatic Artery
  • Humans
  • Injections, Intra-Arterial
  • Liver Neoplasms / blood supply
  • Liver Neoplasms / radiotherapy*
  • Liver Neoplasms / surgery
  • Male
  • Microspheres
  • Middle Aged
  • Yttrium Radioisotopes / administration & dosage*
  • Yttrium Radioisotopes / adverse effects

Substances

  • Biomarkers, Tumor
  • Yttrium Radioisotopes