New concepts and technologies in interventional radiotherapy for hepatocellular carcinoma guided by the paradigm of precision surgery

DONG Jia-hong; ZHANG Lin; FENG Xiao-bin

doi:10.19538/j.cjps.issn1005-2208.2024.09.04

Abstract：Under the paradigm of precision surgery,interventional radiotherapy for hepatocellular carcinoma(HCC),particularly Yttrium-90 selective internal radiation therapy(SIRT),is becoming a key treatment modality.HCC,a highly malignant gastrointestinal tumor,poses significant public health challenges due to its high incidence and mortality rates.Surgical resection is an effective curative treatment for HCC,but most advanced HCC patients are unresectable when diagnosed.Yttrium-90 SIRT achieves high-dose precision radiation"from the inside out"by directly injecting yttrium-90 microspheres into the tumor-feeding arteries.The success of this technique relies on precise preoperative assessment and planning,accurate intraoperative procedures,and meticulous postoperative management and monitoring to ensure treatment efficacy and safety.Yttrium-90 SIRT can reduce tumor size,increase residual liver volume and eliminate portal vein tumor thrombus,playing an important role in the downgrading treatment of HCC,creating surgical resection opportunities for unresectable tumors,thereby improving long-term survival rates.Under the guidance of precision surgery,the efficacy and safety of interventional radiation therapy for HCC will be better optimized via furtherly standardized and innovative applications.With the collaboration of a multidisciplinary team(MDT),individualized treatment plans,and standardized intraoperative procedures,yttrium-90 SIRT holds broad prospects in HCC management.In the future,as clinical experience accumulates and technology advances,yttrium-90 SIRT is expected to play an increasingly important role in improving HCC cure rates,optimizing treatment processes,reducing side effects,and improving quality of life.