Selective internal radiation therapy by yttrium-90 microspheres for hepatocellular carcinoma after renal transplantation

We report a HBsA-positive patient who developed hepatocellular carcinoma (H CC) 7 years after cadaveric kidney transplantation. The tumor was unresecta ble because of coexisting cirrhosis. Selective internal radiation (SIR) the rapy, a novel therapy with the technique recently perfected, was used. Yttr ium-90 microspheres were given via an angiographic catheter under fluorosco py guidance. Serum alpha-fetal protein (AFP) was normalized within 2 wk. A follow-up abdominal CT scan revealed significant necrosis of the tumor and compensatory hypertrophy of non-diseased liver. The treatment was well tole rated except for transient liver function deterioration. The patient enjoye d 15 months of symptom-free survival before she died of liver failure. Prac tical aspects and potential applications of SIR therapy in this group of pa tients are discussed.