Underlying liver disease influences volumetric changes in the spared hemiliver after selective internal radiation therapy with Y-90 in patients with hepatocellular carcinoma

作者：Teo Jin Yao; Goh Brian Kim Poh; Cheah Foong Koon; Allen John Carson; Lo Richard Hoau Gong; Ng David Chee Eng; Goh Anthony Soon Whatt; Khor Andrew Yu Keat; Sim Hui Shan; Ng Jia Jun; Chow Pierce Kah Hoe^*

来源：Journal of Digestive Diseases, 2014, 15(8): 444-450.

DOI：10.1111/1751-2980.12162

• hepatitis B
• hepatocellular carcinoma
• hypertrophy
• liver cirrhosis
• selective internal radiation therapy

OBJECTIVE: Hypertrophy of the contralateral liver lobe after treatment with yttrium-90 (Y-90) microspheres has recently been reported. This study aimed to quantify left hepatic lobe hypertrophy after right-sided radioembolization for hepatocellular carcinoma (HCC) and to identify pretreatment predictive factors of hypertrophy in an Asian population.
METHODS: A retrospective review of patients with inoperable HCC undergoing selective internal radiation treatment (SIRT) with Y-90 microspheres at a single institution from January 2008 to January 2012 was performed. Only patients who had treatment delivered via the right hepatic artery alone were included.
RESULTS: In all, 17 patients fulfilling the study criteria were identified. The mean percentage of left-lobe hypertrophy was 34.2% +/- 34.9% (range 19.0-106.5%) during a median of 5-month follow-up. Patients with hepatitis B were found to experience a significantly greater degree of hypertrophy than those with hepatitis C or alcoholic liver cirrhosis. There were no cases of acute liver failure after the administration of SIRT in this study and none of the patients developed disease in the contralateral lobe over the study period.
CONCLUSIONS: Administration of unilobar SIRT to the right liver lobe in patients with HCC resulted in a significant degree of contralateral left lobe hypertrophy. Patients with hepatitis B experienced a greater degree of hypertrophy than those with hepatitis C or alcoholic liver cirrhosis.

• 出版日期2014-8