Skip to main content
SpringerLink
Log in

Outcome of Transarterial Radioembolization in the Treatment of Hepatocellular Carcinoma: Glass Versus Resin Microsphere

  • Clinical Investigation
  • Interventional Oncology
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

  • 2 Altmetric

Abstract

Purpose

To compare the treatment outcomes of glass and resin microspheres for the treatment of hepatocellular carcinoma (HCC) and evaluate the prognostic factors that influence the outcomes.

Materials and Methods

We retrospectively reviewed 251 consecutive patients who underwent radioembolization for the treatment of HCC at a single tertiary center. Imaging responses after radioembolization were evaluated using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) 1.1. Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan–Meier method. Univariate and multivariate Cox proportional hazard models were used to identify the prognostic factors.

Results

A total of 195 patients were included in this study (glass microsphere, n = 75; resin microsphere, n = 120). The complete and objective response rates were 16.0% and 50.7% in the glass microsphere group and 17.5% and 58.3% in the resin microsphere group, respectively. Median PFS was 241 days in the glass microsphere group and 268 days in the resin microsphere group (p = 0.871). Median OS was 29 months in the glass microsphere group and 40 months in the resin microsphere group (p = 0.669). The only significant prognostic factor was bilobar tumor distribution, which favored resin microspheres (p = 0.023). Procedure-related adverse events occurred more frequently in the resin microsphere group (glass, 2.7% vs. resin, 5.0%; p < 0.001).

Conclusion

Glass and resin microspheres for the treatment of HCC did not show a significant difference in survival, though major adverse events occurred more frequently with the use of resin microspheres.

Graphical Abstract

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Guiu B, Garin E, Allimant C, Edeline J, Salem R. TARE in hepatocellular carcinoma: from the right to the left of BCLC. Cardiovasc Intervent Radiol. 2022;45(11):1599–607.

    Article  PubMed  Google Scholar 

  2. Chow PKH, Gandhi M, Tan SB, et al. SIRveNIB: selective internal radiation therapy versus sorafenib in Asia-Pacific patients With hepatocellular carcinoma. J Clin Oncol. 2018;36(19):1913–21.

    Article  CAS  PubMed  Google Scholar 

  3. Vilgrain V, Pereira H, Assenat E, et al. Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma (SARAH): an open-label randomised controlled phase 3 trial. Lancet Oncol. 2017;18(12):1624–36.

    Article  CAS  PubMed  Google Scholar 

  4. Garin E, Tselikas L, Guiu B, et al. Personalised versus standard dosimetry approach of selective internal radiation therapy in patients with locally advanced hepatocellular carcinoma (DOSISPHERE-01): a randomised, multicentre, open-label phase 2 trial. Lancet Gastroenterol Hepatol. 2021;6(1):17–29.

    Article  PubMed  Google Scholar 

  5. Salem R, Johnson GE, Riaz A, Bishay VL, Kim E, Padia S. Yttrium-90 glass microspheres in the treatment of hepatocellular carcinoma: the LEGACY study. Cardiovasc Intervent Radiol. 2020;43(Suppl 4):163.

    Google Scholar 

  6. Reig M, Forner A, Rimola J, et al. BCLC strategy for prognosis prediction and treatment recommendation: the 2022 update. J Hepatol. 2022;76(3):681–93.

    Article  PubMed  Google Scholar 

  7. Salem R, Thurston KG. Radioembolization with 90Yttrium microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies. Part 1: technical and methodologic considerations. J Vasc Interv Radiol. 2006;17(8):1251–78.

    Article  PubMed  Google Scholar 

  8. Salem R, Thurston KG, Carr BI, Goin JE, Geschwind JF. Yttrium-90 microspheres: radiation therapy for unresectable liver cancer. J Vasc Interv Radiol. 2002;13(9 Pt 2):S223-229.

    Article  PubMed  Google Scholar 

  9. Kao YH, Tan EH, Ng CE, Goh SW. Clinical implications of the body surface area method versus partition model dosimetry for yttrium-90 radioembolization using resin microspheres: a technical review. Ann Nucl Med. 2011;25(7):455–61.

    Article  PubMed  Google Scholar 

  10. Lam M, Garin E, Maccauro M, et al. A global evaluation of advanced dosimetry in transarterial radioembolization of hepatocellular carcinoma with Yttrium-90: the TARGET study. Eur J Nucl Med Mol Imaging. 2022;49(10):3340–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Watanabe M, Grafe H, Theysohn J, et al. Voxel-based dosimetry predicts hepatotoxicity in hepatocellular carcinoma patients undergoing radioembolization with (90)Y glass microspheres. J Nucl Med. 2023;64(7):1102–8.

    Article  CAS  PubMed  Google Scholar 

  12. Van Der Gucht A, Jreige M, Denys A, et al. Resin versus glass microspheres for (90)Y transarterial radioembolization: comparing survival in unresectable hepatocellular carcinoma using pretreatment partition model dosimetry. J Nucl Med. 2017;58(8):1334–40.

    Article  PubMed  Google Scholar 

  13. Kallini JR, Gabr A, Thorlund K, et al. Comparison of the adverse event profile of TheraSphere((R)) with SIR-Spheres((R)) for the treatment of unresectable hepatocellular carcinoma: a systematic review. Cardiovasc Intervent Radiol. 2017;40(7):1033–43.

    Article  PubMed  Google Scholar 

  14. Biederman DM, Titano JJ, Tabori NE, et al. Outcomes of radioembolization in the treatment of hepatocellular carcinoma with portal vein invasion: resin versus glass microspheres. J Vasc Interv Radiol. 2016;27(6):812–21.

    Article  PubMed  Google Scholar 

  15. Heimbach JK, Kulik LM, Finn RS, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2018;67(1):358–80.

    Article  PubMed  Google Scholar 

  16. Marrero JA, Kulik LM, Sirlin CB, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American Association for the study of liver diseases. Hepatology. 2018;68(2):723–50.

    Article  PubMed  Google Scholar 

  17. Korean Liver Cancer A, National Cancer Center K. KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma. Korean J Radiol. 2022;23(12):1126–240.

    Article  Google Scholar 

  18. Kwon JH, Kim GM, Han K, et al. Safety and efficacy of transarterial radioembolization combined with chemoembolization for bilobar hepatocellular carcinoma: a single-center retrospective study. Cardiovasc Intervent Radiol. 2018;41(3):459–65.

    Article  PubMed  Google Scholar 

  19. Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis. 2010;30(1):52–60.

    Article  CAS  PubMed  Google Scholar 

  20. Filippiadis DK, Binkert C, Pellerin O, Hoffmann RT, Krajina A, Pereira PL. Cirse quality assurance document and standards for classification of complications: the cirse classification system. Cardiovasc Intervent Radiol. 2017;40(8):1141–6.

    Article  CAS  PubMed  Google Scholar 

  21. Frantz S, Matsuoka L, Vaheesan K, et al. Multicenter evaluation of survival and toxicities of hepatocellular carcinoma following radioembolization: analysis of the RESiN registry. J Vasc Interv Radiol. 2021;32(6):845–52.

    Article  PubMed  Google Scholar 

  22. Helmberger T, Golfieri R, Pech M, et al. Clinical application of trans-arterial radioembolization in hepatic malignancies in Europe: first results from the prospective multicentre observational study CIRSE registry for SIR-spheres therapy (CIRT). Cardiovasc Intervent Radiol. 2021;44(1):21–35.

    Article  PubMed  Google Scholar 

  23. Sangro B, Carpanese L, Cianni R, et al. Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma across Barcelona clinic liver cancer stages: a European evaluation. Hepatology. 2011;54(3):868–78.

    Article  PubMed  Google Scholar 

  24. Cardarelli-Leite L, Chung J, Klass D, et al. Ablative transarterial radioembolization improves survival in patients with HCC and portal vein tumor thrombus. Cardiovasc Intervent Radiol. 2020;43(3):411–22.

    Article  PubMed  Google Scholar 

  25. Golfieri R, Bilbao JI, Carpanese L, et al. Comparison of the survival and tolerability of radioembolization in elderly vs. younger patients with unresectable hepatocellular carcinoma. J Hepatol. 2013;59(4):753–61.

    Article  PubMed  Google Scholar 

  26. Pasciak AS, Abiola G, Liddell RP, et al. The number of microspheres in Y90 radioembolization directly affects normal tissue radiation exposure. Eur J Nucl Med Mol Imaging. 2020;47(4):816–27.

    Article  CAS  PubMed  Google Scholar 

  27. Salem R, Johnson GE, Kim E, et al. Yttrium-90 radioembolization for the treatment of solitary unresectable HCC: the LEGACY study. Hepatology. 2021;74(5):2342–52.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea

    Gyoung Min Kim, Jong Yun Won & Sungmo Moon

  2. Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, 50-1, Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea

    Do Young Kim, Seung Up Kim & Beom Kyung Kim

Authors
  1. Gyoung Min Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Do Young Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jong Yun Won
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sungmo Moon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Seung Up Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Beom Kyung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Do Young Kim.

Ethics declarations

Conflicts of interest

Nothing to declare.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 158 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, G.M., Kim, D.Y., Won, J.Y. et al. Outcome of Transarterial Radioembolization in the Treatment of Hepatocellular Carcinoma: Glass Versus Resin Microsphere. Cardiovasc Intervent Radiol (2024). https://doi.org/10.1007/s00270-024-03726-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00270-024-03726-9

Keywords

Search

Navigation