Impact of Y90 Radiation Segmentectomy on HCC

The Impact of 90Yttrium (Y90) Radiation Segmentectomy on Hepatocellular Carcinoma and Cirrhosis

The aim of this pilot study is to assess the efficacy of radiation segmentectomy with Theraspheres in patients with unresectable hepatocellular carcinoma that would qualify for thermal ablation as per the BCLC guidelines, but are unable to receive thermal ablation due to unfavorable location of target lesions.

Inclusion Criteria:

• Age greater than 18 years, regardless of race or gender
• Hepatocellular Carcinoma confirmed by histology for non-cirrhotic patients or non-invasive criteria according to AASLD for cirrhotic patients
• Child-Pugh class A or B7 without ascites
• Single tumor nodule ≤ 3 cm with a maximum distance of 5 mm from portal vein, hepatic vein, inferior vena cava, diaphragm, heart, stomach, bowel, liver capsule, gallbladder, bile duct
• No prior locoregional treatment or external beam therapy of current HCC (recurrent HCC after resection may be included)
• No confirmed extrahepatic metastases
• No evidence of macrovascular invasion
• ECOG 0
• Albumin > 3.0 g/dL
• PLT ≥ 40 x103/μL
• WBC ≥ 1.5 x103/μL
• AST/ALT ≤ 5 times the upper limit of normal (U/L)
• Creatinine ≤ 2.0 mg /dL
• No indication for any possible curative treatment after multidisciplinary assessment (surgery, ablation)
• No contraindication to angiography or selective visceral catheterization
• No history of severe allergy or intolerance to contrast agents, narcotics, sedatives.
• Negative serum pregnancy test
• Signed informed consent form

Exclusion Criteria:

• Not meeting the inclusion criteria