Ibrahim SM, Lewandowski RJ, Sato KT, Gates VL, Kulik L, Mulcahy MF, Ryu RK, Omary RA, Salem R. Radioembolization for the treatment of unresectable hepatocellular carcinoma: A clinical review. World J Gastroenterol 2008; 14(11): 1664-1669 [PMID: 18350597 DOI: 10.3748/wjg.14.1664]
Corresponding Author of This Article
Riad Salem, MD, MBA, Director, Interventional Oncology, Department of Radiology, Section of Interventional Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 800, Chicago 60611, United States. r-salem@northwestern.edu
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World J Gastroenterol. Mar 21, 2008; 14(11): 1664-1669 Published online Mar 21, 2008. doi: 10.3748/wjg.14.1664
Radioembolization for the treatment of unresectable hepatocellular carcinoma: A clinical review
Saad M Ibrahim, Robert J Lewandowski, Kent T Sato, Vanessa L Gates, Laura Kulik, Mary F Mulcahy, Robert K Ryu, Reed A Omary, Riad Salem
Saad M Ibrahim, Robert J Lewandowski, Kent T Sato, Robert K Ryu, Reed A Omary, Riad Salem, Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Robert H. Lurie Comprehensive Cancer Center, Chicago 60611, United States
Vanessa L Gates, Department of Nuclear Medicine, North-western Memorial Hospital, Chicago 60611, United States
Laura Kulik, Department of Medicine, Division of Hepatology, Northwestern Memorial Hospital, Chicago 60611, United States
Mary F Mulcahy, Riad Salem, Department of Medicine, Division of Hematology and Oncology, Robert H Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, Chicago 60611, United States
Author contributions: Ibrahim SM, Lewandowski RJ, Sato KT, Ryu RK, Omary RA, Vanessa GL, Kulik L, Mulcahy MF, and Salem R contributed equally to this work.
Correspondence to: Riad Salem, MD, MBA, Director, Interventional Oncology, Department of Radiology, Section of Interventional Radiology, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 800, Chicago 60611, United States. r-salem@northwestern.edu
Telephone: +1-312-6956371
Fax: +1-312-6950654
Received: December 4, 2007 Revised: December 30, 2007 Published online: March 21, 2008
Abstract
Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world. The majority of patients with HCC present with unresectable disease. These patients have historically had limited treatment options secondary to HCC demonstrating chemoresistance to the currently available systemic therapies. Additionally, normal liver parenchyma has shown intolerance to tumoricidal radiation doses, limiting the use of external beam radiation. Because of these limitations, novel percutaneous liver-directed therapies have emerged. The targeted infusion of radioactive microspheres (radioembolization) represents one such therapy. Radioembolization is a minimally invasive transcatheter therapy through which radioactive microspheres are infused into the hepatic arteries that supply tumor. Once infused, these microspheres traverse the hepatic vascular plexus and selectively implant within the tumor arterioles. Embedded within the arterioles, the 90Y impregnated microspheres emit high energy and low penetrating radiation doses selectively to the tumor. Radioembolization has recently shown promise for the treatment of patients with unresectable HCC. The objective of this review article is to highlight two currently available radioembolic devices (90Y, 188Rh) and provide the reader with a recent review of the literature.
