7 The main radioactive agent integrated with microspheres for radioembolization or selective internal radiotherapy (SIRT) is yttrium-90 (Y-90), although other agents have been reported. To date, two products for radioembolization with Y-90 microspheres are commercially available, based on resin or glass. Due to a smaller size and a significantly higher amount of radioactivity per single sphere,8 glass microspheres do not show embolizing effects on larger tumor vessels. This limits exposure to surrounding liver tissue and allows glass microspheres to be utilized

in the presence of portal vein thrombosis.7 We report the analysis of 108 consecutive cases with intrahepatic advanced HCC treated with Y-90 glass microsphere radioembolization. The Linsitinib aim of this study was to provide evidence on the safety of this therapy CH5424802 solubility dmso in this particular group of patients and to determine long-term survival, which has to be considered the most significant clinical endpoint. AE, adverse event; AFP, alphafetoprotein; BCLC, Barcelona Clinic Liver Cancer; HCC, hepatocellular carcinoma; MAA, macroaggregated albumin;

PVT, portal vein thrombosis; RECIST, Response Evaluation Criteria in Solid Tumors; SIRT, selective internal radiotherapy; SPECT, single photon emission computed tomography; TACE, transarterial chemoembolization; Phospholipase D1 Tc-99, technetium-99; TTP, time to progression; RILD, radiation-induced liver disease; Y-90, yttrium-90. In all, 108 consecutive patients with advanced HCC who were treated with radioembolization with Y-90 glass microspheres at a single center (University Hospital Essen, Germany) between November 2006 and March 2009 were included in this observational

cohort study. The indication for Y-90 treatment was driven by an institutional algorithm based on the BCLC treatment scheme. Patients were routinely staged by a 3-phase computed tomography (CT) or magnetic resonance imaging (MRI) of the liver, a contrast-enhanced ultrasound to further determine vascularity, as well as a CT of the lungs. If alphafetoprotein (AFP) was >400 ng/mL, patients additionally received a technetium-99 (Tc-99)-based bone scan. The major clinical features allowing Y-90 treatment and therefore inclusion into this observational study were nonresectability of HCC and BCLC C tumor stage. Patients with BCLC A and B were also included if they were not eligible for selective TACE. Additional inclusion criteria were adequate hypervascularity (concentration and consecutive “blush” of contrast agent in the arterial phase of CT and/or contrast-enhanced ultrasound), a liver function with a Child-Turcotte-Pugh (CTP) score ≤7 points, and an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, or 2.