Background and aim: Nowadays there are several treatments for hepatocellular carcinoma BCLC B, among them is radioembolization with Itrio-90 (RE-Y90) which is a form of locoregional intra-arterial brachytherapy towards HCC, among its advantages is prolonging the HCC progression time and improve the quality of life of patients. Adverse effects could be extrahepatic (radiation pneumonitis) and intrahepatic (radiation-induced liver disease), among others. Objective of our work is to assess the time free of progression, response to treatment and adverse effects that occur with the administration of RE-Y90.
Material and methods: All HCC BCLC B patients who were candidates for RE-Y90 were analyzed.
Inclusion criteria: cirrhotic patients of any etiology, with a diagnosis of HCC stage B, Child Pugh A and B with 7 points, who had previously undergone a morphological study (CT / MRI) and arteriography to characterize the lesion, to know the irrigation of the tumor and rule out extrahepatic shunts that contraindicate the application of RE-Y90. Subsequently, the procedure was simulated with MAA-Tc99m in order to record its distribution, perform dosimetry, and on the day of RE-Y90, an image study was performed with PET / CT in order to verify the distribution. Exclusion criteria. Patients with liver cirrhosis of any etiology with BCLC Stage B of the Child Pugh B plus 7 points or those with Child Pugh A or B 7 points with extrahepatic shunts. Do not accept this type of therapy. Patients who were not candidates for this therapy were sessioned at the Gastrointestinal and Liver Tumor Meeting to decide their treatment. Response to treatment at 3 and 6 months was analyzed using the mRECIST criteria, progression-free time at 6 months, and adverse effects were recorded.
Results: Two patients with HCC BCLC B, a 70-year-old woman with HCC from AIH and a 67-year-old man with HCC of alcohol etiology, both Child Pugh at 6 points, with no data on arterial thrombosis, were performed.
After RE-Y90, there were no complications and the patients were discharged after 24hours.
Control Computed Axial Tomography was performed with good response, without disease progression at 3 and 6 months, asymptomatic.
Conclusions: RE-Y90 for the treatment of BCLC stage B HCC is a good therapeutic option in well selected patient.
Conflicts of interest: The authors have no conflicts of interest to declare.
