Research by Lewandowski et al published in Radiology suggests that patients with small hepatocellular carcinomas (HCC) respond favorably to intra-arterial treatment with yttrium-90.
The authors reported outcomes from a retrospective analysis of 70 patients with HCC that were less or equal to 5 cm. The patients received a radiation dose of more than 190 Gy.
Sixty-three patients (90%) showed response by using European Association for the Study of the Liver (EASL) criteria, of which 41 (59%) showed complete response. Fifty patients (71%) achieved response by using World Health Organization (WHO) criteria, of which 11 (16%) achieved complete response. Response rates at 6 months were 86% and 49% by using EASL and WHO criteria, respectively. Median overall survival was 6.7 years; survival probability at 1, 3, and 5 years was 98%, 66%, and 57%, respectively. Overall survival probability at 1, 3, and 5 years was 100%, 82%, and 75%, respectively, in patients with baseline tumor size less than or equal to 3 cm (n = 45) and was significantly longer than in patients with tumors greater than 3 cm (P = .026).
The authors concluded that RS provides tumor control, and survival outcomes comparable to curative-intent treatments for patients with early-stage HCC who have preserved liver function.
