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Single-system outcomes after adopting yttrium-90 radioembolization with personalized dosimetry as the primary treatment approach for unresectable, solitary hepatocellular carcinoma
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DOI：10.1016/j.esmogo.2026.100309.png)
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Abstract
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Background: Yittrium-90 (Y-90) radioembolization has emerged as a secondary treatment option for early- to intermediate-stage hepatocellular carcinoma (HCC) in the Barcelona Clinic Liver Cancer (BCLC) Staging and Treatment Algorithm. Several trials have recently shown that Y-90 is a safe and effective primary treatment option for BCLC stages A and B. In this study, the outcomes for three treatment centers within a single health system with experience utilizing Y-90 as a definitive treatment option for early-stage HCC (BCLC-A) were analyzed in the context of results reported by the DOSISPHERE-01 and TARGET clinical trials. Materials and methods: The cohort was derived from multiple treatment centers within a single health system that utilized Y-90 as the primary option for BCLC-A solitary, unresectable HCC >3 cm and as a secondary option for HCC <3 cm, both with an Eastern Cooperative Oncology Group score of 0-1 and Child-Pugh A5-B9 (n = 171, 2018-2024). The study outcomes included first-cycle objective response (OR) and complete response (CR) rates, target time to retreatment (tTTR), time to BCLC-C progression, progression-free survival (PFS), and overall survival (OS). Results: Patients were enrolled between 2018 and 2024 (n = 171). OS rates at 1 and 3 years were 94% and 73%, with 1- and 3-year PFS rates of 89% and 61%, respectively. Response to first-cycle Y-90 could be assessed in 166 patients. The overall OR rate was 98% (163/166), with 71% (118/166) achieving a target CR. Patients who obtained a target CR had reduced progression rates at 1 year (2% versus 16%) and 3 years (21% versus 62%) compared with incomplete responders. The median tTTR in patients who achieved a target CR was 48 months, with 1- and 2-year retreatment rates of 9% and 24%, respectively. Conclusion: First-cycle Y-90 radioembolization with personalized dosimetry is an effective treatment option for early-stage, solitary HCC that yields high, sustained response rates.
Keywords:
hepatocellular carcinoma
yttrium-90
radioembolization
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