Journal of Clinical Hepatology
Yttrium-90 selective internal radiotherapy, or SIRT, delivers radiation directly to liver tumours through tiny microspheres injected into their arterial blood supply. This study examined its short-term effectiveness in people with hepatocellular carcinoma that could not be surgically removed.
Researchers retrospectively analysed 73 patients treated with SIRT. Based on tumour characteristics, physical condition and liver function, nine received radiation segmentectomy with potentially curative intent, 47 received treatment intended to make further curative therapy possible, and 17 received palliative treatment.
Disease was controlled in all nine patients in the radiation segmentectomy group, 83.0% of the conversion-treatment group and 29.4% of the palliative group. Response rates also differed significantly among the three groups.
Patients with fewer tumours were more likely to achieve a complete response. Receiving targeted therapy and immunotherapy alongside SIRT was also associated with a greater likelihood of complete response. However, the estimate for combined treatment had a wide confidence interval, indicating substantial uncertainty.
Because patients were assigned to treatment strategies according to their disease characteristics rather than randomly, the differences between groups cannot be attributed to SIRT strategy alone.
Many people with hepatocellular carcinoma cannot undergo surgery when first diagnosed. SIRT may serve several purposes: locally destroying a small tumour, reducing disease enough to permit subsequent treatment, or controlling advanced cancer.
The findings support matching SIRT goals to tumour burden and suggest that patients with fewer tumours may be more likely to achieve complete radiological responses. Combining SIRT with systemic therapy also warrants further investigation.
However, this was a small, single-centre retrospective study with a short observation period. It did not assess overall survival and cannot establish whether combined targeted immunotherapy caused the improved responses. Larger prospective comparative studies are required.
Objective: To investigate the efficacy of selective internal radiation therapy (SIRT) in patients with unresectable hepatocellular...
