AccScience Publishing / ARNM / Volume 1 / Issue 1 / DOI: 10.36922/arnm.0385
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Safety and effectiveness of selective internal radiation therapy with SIR-Spheres Y-90 resin microspheres for treatment of hepatocellular carcinoma: A prospective observational study

Khoa Mai Trong1† Bang Mai Hong2† Thong Pham Minh3 Luu Vu Dang3 Binh Tran Hai4 Chau Ha Trinh3 Thinh Nguyen Tien2 Ky Thai Doan2 Thai Pham Van1 Anh Nguyen Duy1 Phuong Pham Cam1*
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1 The Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam
2 Department of Gastroenterology, 108 Military Central Hospital, Hanoi, Vietnam
3 The Radiology Center, Bach Mai Hospital, Hanoi, Vietnam
4 Department of Oncology, Tam Anh Hospital, Hanoi, Vietnam
Submitted: 1 April 2023 | Accepted: 18 June 2023 | Published: 5 July 2023
© 2023 by the Author(s). Licensee AccScience Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( )

The study aimed to evaluate the safety and effectiveness of selective internal radiation therapy (SIRT) in patients with unresectable hepatocellular carcinoma (HCC) in Vietnam. A single-arm, multicenter, prospective observational study on the use of SIRT in patients with HCC was conducted with 6 months of patient follow-up. At baseline, eligible patients had Eastern Cooperative Oncology Group (ECOG) status ≤1, total bilirubin ≤2 mg/dL, tumor burden ≤50%, Child-Pugh score A or ≤B7, and Barcelona Clinic Liver Cancer stage A – C. Patients with extrahepatic disease, signs of liver failure, or previous external beam radiation to the liver were excluded. Primary outcomes were tumor response according to modified Response Evaluation Criteria in Solid Tumors criteria, changes in liver function, and adverse events (AEs) assessed using Common Terminology for AEs v4.03 and the investigators’ clinical judgment. The secondary outcome was the percentage of patients alive at 6 months. Two centers enrolled 30 patients (median age 60 years) in 2017 and 2018. All patients were Child-Pugh A; among them, 28 were ECOG 0. Most had hepatitis B (n = 17, 57%) or D (n = 10, 33%). Target lesion response at 6 months was 23% complete response, 37% partial response, 7% stable disease, and 7% progressive disease. Of the 8 patients (27%) not evaluated, 2 had become eligible for resection, 2 had contraindications to imaging, and 4 were lost to follow-up. Laboratory values, including α-fetoprotein, did not change significantly from baseline to 6 months. The most common AEs were abdominal pain (37%) and vomiting (17%). Nine episodes of abdominal pain in 6 patients were treatment-related. Serious AEs included progressive cirrhosis (n = 1) and progression of HCC (n = 5). All patients were alive at 6 months. In conclusion, the safety and clinical effectiveness of SIRT were confirmed in patients with unresectable HCC in Vietnam.

Unresectable hepatocellular carcinoma
Selective internal radiation therapy
Liver cancer
SIRTEX company
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Conflict of interest
The authors declare no competing of interest.
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Advances in Radiotherapy & Nuclear Medicine, Electronic ISSN: 2972-4392 Print ISSN: TBA, Published by AccScience Publishing