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Background <p>Surgical resection offers long-term survival for liver malignancies, but insufficient future liver remnant (FLR) volume often precludes operability. This study evaluated yttrium-90 selective internal radiation therapy (<sup>90</sup>Y-SIRT) for controlling right-liver tumors and inducing compensatory left-lobe hyperplasia. Results: Thirty-seven patients (29 hepatocellular carcinomas, 2 intrahepatic cholangiocarcinoma, 6 liver metastasis of colorectal cancer) with right-liver tumors underwent <sup>90</sup>Y-SIRT. Tumor volume decreased significantly by 133 mL at 1 month and 206 mL at 3 months post-treatment (both <i>P</i> &lt; 0.001). Right-liver volume reduction averaged 182 mL at 1 month (<i>P</i> &lt; 0.001) and 300 mL at 3 months (<i>P</i> &lt; 0.001). Concurrently, left-liver volume increased by 55 mL (<i>P</i> &lt; 0.001) and 127 mL (<i>P</i> &lt; 0.001) at 1 and 3 months, respectively, while FLR percentage rose by 5.8% (<i>P</i> &lt; 0.001) and 11.9% (<i>P</i> &lt; 0.001). Per mRECIST criteria, 3-month imaging revealed an objective response rate (ORR) of 78.4% and disease control rate (DCR) of 91.9%. In 14 patients downstaged to resection/transplantation, ICG-R15 levels remained stable, confirming preserved liver reserve function post-90Y-SIRT. These findings demonstrate <sup>90</sup>Y-SIRT effectively controls right-lobe tumor progression and stimulates compensatory left-lobe hypertrophy, enabling FLR expansion. The treatment achieved high ORR, significant tumor downstaging, and pathological necrosis without compromising hepatic functional reserve. Conclusions: 90Y-SIRT represents a safe and efficacious strategy to convert initially unresectable patients into surgical candidates.</p>

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Yttrium-90 selective internal radiation therapy for right hepatic malignancies: a clinical outcome study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月1日

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  • Xin Huang,
  • Yong Liao,
  • Ziwei Liang,
  • Junpeng Ma,
  • Bin Liang,
  • Shizhong Yang,
  • Guangxin Li,
  • Tiantian Zhang,
  • Linxia Zheng,
  • Yafei Zhang,
  • Mulan Tang,
  • Bo Jia,
  • Lin Zhang,
  • Xiaobin Feng

摘要

Background

Surgical resection offers long-term survival for liver malignancies, but insufficient future liver remnant (FLR) volume often precludes operability. This study evaluated yttrium-90 selective internal radiation therapy (90Y-SIRT) for controlling right-liver tumors and inducing compensatory left-lobe hyperplasia. Results: Thirty-seven patients (29 hepatocellular carcinomas, 2 intrahepatic cholangiocarcinoma, 6 liver metastasis of colorectal cancer) with right-liver tumors underwent 90Y-SIRT. Tumor volume decreased significantly by 133 mL at 1 month and 206 mL at 3 months post-treatment (both P < 0.001). Right-liver volume reduction averaged 182 mL at 1 month (P < 0.001) and 300 mL at 3 months (P < 0.001). Concurrently, left-liver volume increased by 55 mL (P < 0.001) and 127 mL (P < 0.001) at 1 and 3 months, respectively, while FLR percentage rose by 5.8% (P < 0.001) and 11.9% (P < 0.001). Per mRECIST criteria, 3-month imaging revealed an objective response rate (ORR) of 78.4% and disease control rate (DCR) of 91.9%. In 14 patients downstaged to resection/transplantation, ICG-R15 levels remained stable, confirming preserved liver reserve function post-90Y-SIRT. These findings demonstrate 90Y-SIRT effectively controls right-lobe tumor progression and stimulates compensatory left-lobe hypertrophy, enabling FLR expansion. The treatment achieved high ORR, significant tumor downstaging, and pathological necrosis without compromising hepatic functional reserve. Conclusions: 90Y-SIRT represents a safe and efficacious strategy to convert initially unresectable patients into surgical candidates.