Radionuclide therapy for hepatocellular carcinoma: indication, cost and efficacy.

Simple item page
dc.contributor.authorBal, C Sen_US
dc.contributor.authorKumar, Aen_US
dc.date.accessioned2008-04-01en_US
dc.date.accessioned2009-06-04T04:19:00Z
dc.date.available2008-04-01en_US
dc.date.available2009-06-04T04:19:00Z
dc.date.issued2008-04-01en_US
dc.description98 references.en_US
dc.description.abstractA large number of patients with hepatocellular carcinoma (HCC) will have large and/or multiple inoperable tumours, precluding percutaneous ablation, such as percutaneous ethanol, acetic acid or hot saline injection, and radiofrequency ablation. Similarly, if the tumour is not accessible percutaneously or the tumour is subcapsular or subdiaphragmatic, percutaneous therapy is ruled out. Many patients will also have associated portal vein thrombosis, making them unsuitable for chemoembolisation, depending upon the level and severity of thrombosis. Such patients can be offered internal radioisotope therapy to prolong their survival and improve the quality of life. The aim of radioisotope therapy is to deliver the radioisotope to the hepatic tumour, where it must reside for a period sufficient to deliver the scheduled dose of radiation. At the same time the amount delivered to the normal liver parenchyma and other organs should be as low as possible. A variety of radioisotopes, such as lodine-131, Yttrium-90, Rhenium-188, Holmium-166 etc. can be used for this purpose and targeting of the therapeutic agent to the tumour may be achieved by 1) direct intra-tumour implantation of the radioisotope, 2) parenteral injection of radiolabelled antibodies specific to HCC antigens (radioimmunotherapy) or, 3) injecting the radioisotope through the hepatic artery directly into the tumour or trans-arterial radioisotope therapy (TART). The radioisotope therapy appears to be a very reasonable and effective therapeutic alternative, a) for the treatment of large inoperable HCC, particularly with portal vein thrombosis, b) treatment of small inoperable tumours unsuitable for percutaneous therapy because of any reason, c) as a neoadjuvant therapy before hepatic transplantation to reduce the risk of recurrence in the graft or before hepatic resection to shrink the tumour size, and d) as an adjuvant therapy, after surgery or percutaneous ablative therapy to reduce the risk of recurrence. Further, it can be very affordable if generator produced Re-188 is used, which appears to be equally or more effective and useful than other currently available radioisotopes. The availability of Re-188 in a generator form makes its storage, transportation, elution and usage very convenient and cost-effective, particularly at remote places and in developing countries. The use of generator also makes Re-188 available on a constant and need to need basis.en_US
dc.description.affiliationDepartment of Nuclear Medicine & PET, AIIMS, New Delhi, India. csbal@hotmail.comen_US
dc.identifier.citationBal CS, Kumar A. Radionuclide therapy for hepatocellular carcinoma: indication, cost and efficacy. Tropical Gastroenterology. 2008 Apr-Jun; 29(2): 62-70en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/124844
dc.language.isoengen_US
dc.source.urihttps://www.tropicalgastro.comen_US
dc.subject.meshBrachytherapy --economicsen_US
dc.subject.meshCarcinoma, Hepatocellular --pathologyen_US
dc.subject.meshCost-Benefit Analysisen_US
dc.subject.meshHumansen_US
dc.subject.meshLiver Neoplasms --pathologyen_US
dc.subject.meshRadioimmunotherapy --economicsen_US
dc.subject.meshRadioisotopes --economicsen_US
dc.titleRadionuclide therapy for hepatocellular carcinoma: indication, cost and efficacy.en_US
dc.typeJournal Articleen_US
dc.typeReviewen_US
Files
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.79 KB
Format:
Plain Text
Description:
Download
Collections
Tropical Gastroenterology