Vigneron Paul, Franzè Maria Stella, Chalaye Julia, Tacher Vania, Sessa Anna, Luciani Alain, Kobeiter Hicham, Regnault Hélène, Bejan Ancuta, Calderaro Julien, Rhaiem Rami, Sommacale Daniele, Raimondo Giovanni, Leroy Vincent, Brustia Raffaele, Amaddeo Giuliana
Department of Hepatology, Assistance Publique-Hôpitaux de Paris, Henri Mondor-Albert Chenevier University Hospital, Créteil, France.
Université Paris-Est Créteil, UPEC, Créteil, France.
Hepatobiliary Surg Nutr. 2024 Dec 1;13(6):974-990. doi: 10.21037/hbsn-23-504. Epub 2024 Jun 6.
Selective internal radiation therapy (SIRT) represents an endovascular treatment option for patients with hepatocellular carcinoma (HCC). Its use is widely recognized in the intermediate and advanced HCC, but it has become more prevalent in recent years in different Barcelona Clinic Liver Cancer (BCLC) stages. The aim of this review is to summarize the role of SIRT and its clinical implications through different stages of HCC.
A literature review of papers on this topic was performed using PubMed MEDLINE, focusing exclusively on the role of yttrium-90 SIRT across all BCLC stages and comparing it with other treatments. Only English-language papers currently available until September 2023 were considered.
Many studies have shown that SIRT is a promising tool with multiple uses, such as tumour control in the context of bridge-to-liver transplantation or resection, tumour downstaging, and curative therapy in selected patients. Therefore, according to the recent update of BCLC staging system criteria, SIRT now emerges as a potential curative treatment for early-stage HCC patients, serving as an alternative when ablation or resection is not feasible. It is also a promising treatment compared to transarterial chemoembolization (TACE) as well as in combination with immunotherapies.
SIRT is a safe and effective treatment for selected patients at all BCLC stages of HCC. Therefore, due to its numerous advantages, SIRT may prove useful in many complex HCC treatment situations in the near future.
Hepatocellular carcinoma (HCC); radioembolization; yttrium-90 (Y); selective internal radiation therapy (SIRT); transarterial radioembolization (TARE).
选择性内放射治疗（SIRT）是肝细胞癌（HCC）患者的一种血管内治疗选择。其在中晚期HCC中的应用已得到广泛认可，近年来在巴塞罗那临床肝癌（BCLC）不同分期中也更为普遍。本综述的目的是总结SIRT在HCC不同阶段的作用及其临床意义。
使用PubMed MEDLINE对该主题的论文进行文献综述，专门关注钇-90 SIRT在所有BCLC分期中的作用，并将其与其他治疗方法进行比较。仅考虑截至2023年9月的英文论文。
许多研究表明，SIRT是一种有多种用途的有前景的工具，例如在桥接肝移植或切除的情况下控制肿瘤、降低肿瘤分期以及对选定患者进行根治性治疗。因此，根据BCLC分期系统标准的最新更新，SIRT现在成为早期HCC患者的一种潜在根治性治疗方法，在消融或切除不可行时可作为替代方案。与经动脉化疗栓塞（TACE）相比以及与免疫疗法联合使用时，它也是一种有前景的治疗方法。
SIRT对HCC所有BCLC分期的选定患者是一种安全有效的治疗方法。因此，由于其众多优点，SIRT在不久的将来可能在许多复杂的HCC治疗情况中发挥作用。
肝细胞癌（HCC）；放射栓塞；钇-90（Y）；选择性内放射治疗（SIRT）；经动脉放射栓塞（TARE）
