Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois, USA.
Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.
Hepatol Commun. 2023 Oct 2;7(10). doi: 10.1097/HC9.0000000000000288. eCollection 2023 Oct 1.
Transarterial radioembolization (TARE) with yttrium-90 (90Y) microspheres has been widely adopted for the treatment of HCC. Recent advances in yttrium-90 (90Y) dosimetry have led to durable local responses. Radiation segmentectomy has become a viable alternative to thermal ablation for early-stage HCC (Barcelona Clinic Liver Cancer 0 and A) and has been commonly used as a bridge to transplant. TARE is also commonly used for downstaging to transplant using traditional lobar dosimetry and radiation segmentectomy techniques. Radiation lobectomy has a dual role in local tumor control and induction of contralateral liver lobe hypertrophy as a bridge to resection for patients with an inadequate future liver remnant. TARE continues to provide disease control for patients with limited vascular invasion and may be an alternative to systemic therapy for patients with localized advanced disease. The potential synergy between TARE and immunotherapy has been recognized, and prospective studies evaluating this combination are needed for patients with Barcelona Clinic Liver Cancer B and C HCC.
经动脉放射性栓塞术（TARE）联合钇-90（90Y）微球已广泛应用于 HCC 的治疗。钇-90（90Y）剂量学的最新进展带来了持久的局部反应。对于早期 HCC（巴塞罗那临床肝癌 0 期和 A 期），放射性肝段切除术已成为热消融的可行替代方法，并且通常被用作移植的桥梁。TARE 也常用于使用传统的叶剂量学和放射性肝段切除术技术进行降期移植。对于未来肝剩余量不足的患者，放射性肝叶切除术具有控制局部肿瘤和诱导对侧肝叶肥大的双重作用，作为切除的桥梁。TARE 继续为血管侵犯有限的患者提供疾病控制，并且对于局部晚期疾病的患者，可能是系统治疗的替代方法。已经认识到 TARE 与免疫疗法之间存在协同作用，需要对巴塞罗那临床肝癌 B 和 C 期 HCC 的患者进行评估这种联合的前瞻性研究。
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