What clinical parameters determine when you treat a large HCC lesion with ablative radiation vs Y-90?

Answer from: Radiation Oncologist at Academic Institution

Based on 3 negative randomized trials that have compared Y-90 to relatively inactive targeted therapy (Sorafenib), Y-90 has no evidence-based role in the treatment of HCC. In fact, systemic therapies have improved and 3 regimens have shown a survival benefit for locally advanced and metastatic HCC. ...

Comments

Radiation Oncologist at Providence Health, St. Joseph Hospital
We need to get you on the ACR Appropriate Use Crit...

Radiation Oncologist at University of Colorado School of Medicine
I agree completely but unfortunately, Y90 is the d...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
I agree totally, ACR and NCCN should put politics ...

Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System
That's quite a scientific argument, @Christopher H...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
Sadly, our tax dollars and insurance premiums made...

Medical Oncologist at Charles A. Sammons Cancer Center at Baylor University Medical Center
Very thoughtful explanation. Y90 is used way more ...

Radiation Oncologist at St Louis University School of Medicine
Dr. @Christopher H. Crane, could you provide citat...

Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
References HCC: SORAMIC: Ricke et al., PMI...

Answer from: Radiation Oncologist at Academic Institution

IR is increasingly offering Y90 radiation ‘segmentectomy’ for patients with a single HCC that is too large for thermal ablation (>3cm). I’m now seeing community IR providing Y90 for lesions that are perfectly amenable to thermal ablation. This Northwestern University retrospecti...

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What clinical parameters determine when you treat a large HCC lesion with ablative radiation vs Y-90?

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