SUPERSELECTIVE RADIOEMBOLIZATION OF HEPATOCELLULAR-CARCINOMA - 5-YEARRESULTS OF A PROSPECTIVE-STUDY

Twenty patients with unresectable hepatocellular carcinoma (HCC) were followed up to 5 years after transarterial radiotherapy with Y-90-resi n particles. Diagnostic radioembolizations of Tc-99m-macroaggregates f acilitated scintigraphic assessment of activity distribution, dose eva luation and final procedural verification. The overall survival rates were 56, 38 and 14% (after 1, 2 and 3 years, resp.). Patients with uni focal HCC and a single feeding artery (n = 7) even presented 83, 67 an d 40% (2 alive after 2.75 and 4 years). With multiple arteries (n = 7) , the longest survival was 26 months. Patients with multifocal HCC sur vived up to 33 months after selective radioembolization. Quality of li fe was improved in all. Survival was positively correlated with absorb ed dose but residual/recurrent tumour occurred even after greater-than -or-equal-to300 Gy. Post-treatment symptoms were minimal (35 applicati ons), pulmonary shunt rates were correctly predicted and pulmonary com plications avoided.