***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: UNLABELLED Yttrium-90 radioembolization ( Y90RE ) is a novel approach to radiation therapy for hepatocellular carcinoma ( HCC ) , never tested in phase 2 studies . Fifty-two patients with intermediate ( n.17 ) to advanced ( n.35 ) HCC were prospect ively recruited to assess , as the primary endpoint , efficacy of Y90RE on time-to-progression ( TTP ) . Secondary endpoints were tumor response , safety , and overall survival ( OS ) .  All patients were Eastern Cooperative Oncology Group ( ECOG ) score 0 - 1 , Child-Pugh class A-B7 .  Y90RE treatments aim ed at a lobar delivery of 120 Gy . Retrospective dosimetric correlations were conducted and related to response . Fifty-eight treatments were performed on 52 patients . The median follow-up was 36 months . The median TTP was 11 months with no significant difference between portal vein thrombosis ( PVT ) versus no PVT ( 7 versus 13 months ) . The median OS was 15 months ( 95 % confidence interval [ CI ] , 12 - 18 months ) with a nonsignificant trend in favor of non-PVT versus PVT patients ( 18 versus 13 months ) . Five complete responses occurred ( 9.6 % ) , and the 2 year-progression rate was 62 % . Objective response was 40.4 % , whereas the disease control rate ( 78.8 % ) significantly affected survival ( responders versus nonresponders : 18.4 % versus 9.1 % ; P = 0.009 ) . Tumor response significantly correlated with absorbed dose in target lesions ( r = 0.60 , 95 % CI , 0.41 - 0.74 , P < 0.001 ) and a threshold of 500 Gy predicted response ( area under the curve , 0.78 ) . Mortality at 30 - 90 days was 0%-3.8 % . Various grade s of reduction in liver function occurred within 6 months in 36.5 % of patients , with no differences among stages . On multivariate analysis , tumor response was the sole variable affecting TTP ( P < 0.001 ) and the second affecting survival ( after Child-Pugh class ) . CONCLUSION Y90RE is an effective treatment in intermediate to advanced HCC , particularly in the case of PVT . Further prospect i ve evaluations comparing Y90RE with conventional treatments are warranted INTRODUCTION For patients with resectable hepatocellular carcinoma ( HCC ) , hepatectomy remains one of the best treatment options to provide long-term survival . However , more than 50 % of the patients have unresectable disease upon diagnosis even though there are no distant metastases . Transarterial chemoembolization ( TACE ) is a well-established treatment option that offers a palliative survival benefit for this group of patients . A better treatment for unresectable HCC has been sought after . There is some evidence that transarterial radioembolization ( TARE ) with the agent yttrium-90 produces encouraging outcomes , especially in patients with portal vein tumor thrombus . This study aims to analyze the outcomes of TARE at our center . METHODS From August 2009 to April 2013 , 16 patients underwent TARE at our center . Sixteen patients with similar tumor characteristics were selected to undergo TACE alone for comparison . A retrospective analysis of the prospect ively collected data of the patients was conducted . Only patients with newly diagnosed primary tumors were included in this study . RESULTS The median survival for patients having TARE was 19.9 versus 14.0 months in the TACE group ( P=0.615 ) . There was no difference in terms of tumor response according to the modified Response Evaluation Criteria in Solid Tumors ( mRECIST ) ( P=0.632 ) . The 1- , 2- and 3-year survival rates in the TARE group were 80.0 % , 30.5 % and 20.3 % respectively . The 1-year survival in the TACE group was 58.3 % ( P=0.615 ) . For patients who had major vascular invasion ( eight in each group ) , the 1- and 2-year survival rates in the TARE group were 62.5 % and 15.6 % respectively , while the 1-year survival in the TACE group was 35.0 % ( P=0.664 ) . CONCLUSIONS The two groups showed similar results in terms of tumor response and overall survival benefit . TARE might provide a survival benefit for patients with major vessel invasion BACKGROUND & AIMS To investigate the safety and adverse event profile of sorafenib plus radioembolization ( Y90 ) compared to Y90 alone in patients awaiting liver transplantation . METHODS 20 patients with HCC were r and omized to Y90 alone ( Group A ) or Y90+sorafenib ( Group B ) . Adverse events , dose reductions , and peri-transplant complications were assessed . RESULTS All patients in the sorafenib group necessitated dose reductions . Seventeen of 20 patients underwent liver transplantation ; median time-to-transplant was 7.8 months ( range : 4.2 - 20.3 ) and similar between groups ( p = 0.35 ) . In the sorafenib group , there were 4/8 peri-transplant ( < 30 days ) biliary complications ( p = 0.029 ) and 3/8 acute rejections ( p = 0.082 ) ; there were none in the Y90-only  group . Survival rates were 70 % ( Group A ) and 72 % ( Group B ) at 3 years ( p = 0.57 ) . CONCLUSIONS The addition of sorafenib to Y90 necessitated dose reductions in all patients awaiting transplantation . Preliminary data suggest that the combination was associated with more peri-transplant biliary complications and potentially trended towards more acute rejections . Caution should be exercised when considering sorafenib in the transplant setting . Further investigation is warranted BACKGROUND The goal of this study was to examine the safety and efficacy of selective internal radioembolization ( SIR ) for hepatocellular carcinoma ( HCC ) with portal vein or caval thrombosis ( VT ) , or both . Recent reports have demonstrated that SIR is safe for patients with HCC , but the impact on efficacy of venous thrombosis is unknown . STUDY DESIGN Prospect i ve single-arm study of the use of Therasphere in patients with unresectable HCC enrolled from January 2004 to June 2007 . Patients were categorized into three groups based on VT status and therapy . RESULTS Fifty-two patients were enrolled : 20 patients without VT who received SIR , 15 patients with VT who were treated , and 17 patients ( 10 with VT ) who were not treated because of preprocedure screening failure . Fifty-eight treatments were administered , with a median of two treatments per patient ( range of one to three treatments ) . Child 's score was different between groups . Of the VT patients treated , 67 % had portal VT , 7 % had cava VT , and 26 % had both . There were no treatment-related deaths . There was no difference in complications among groups ( p = 0.34 ) . Treated patients without thrombosis had a median overall survival of 13.9 months versus 2.7 months for those treated with thrombosis and 5.2 months for the untreated group given best supportive care only ( p = 0.01 ) . CONCLUSIONS SIR is safe in patients with HCC . Although SIR can be delivered with minimal morbidity , there might be no benefit for patients with VT . Continued emphasis on multimodality therapy in this population is needed to improve survival UNLABELLED Radioembolization has been demonstrated to allow locoregional therapy of patients with hepatocellular carcinoma not eligible for transarterial chemoembolization or other local therapies . The aim of this study was to vali date evidence of the safety and efficacy of this treatment in a European sample of patients with advanced hepatocellular carcinoma ( HCC ) . Therefore , 108 consecutive patients with advanced HCC and liver cirrhosis were included .  Yttrium-90 ( Y-90 ) microspheres were administered in a lobar fashion over the right or left branch of the hepatic artery . The response to treatment was evaluated by computed tomography ( CT ) imaging applying Response Evaluation Criteria in Solid Tumors ( RECIST ) and World Health Organization ( WHO ) criteria with recent European Association for the Study of the Liver / National Cancer Institute ( EASL/NCI ) amendments . Time to progression ( TTP ) and overall survival were estimated by the Kaplan-Meier method . In all , 159 treatment sessions were performed ranging between one to three treatments per patient . The mean radiation dose per treatment was 120 ( ± 18 ) Gy . According to EASL criteria , complete responses were determined in 3 % of patients , partial responses in 37 % , stable disease 53 % , and primary progression in 6 % of patients . TTP was 10.0 months , whereas the median overall survival was 16.4 months . No lung or visceral toxicity was observed . The most frequently observed adverse events was a transient fatigue-syndrome . CONCLUSION Radioembolization with Y-90 glass microspheres for patients with advanced HCC is a safe and effective treatment which can be utilized even in patients with compromised liver function . Because TTP and survival appear to be comparable to systemic therapy in selected patients with advanced HCC , r and omized controlled trials in combination with systemic therapy are warranted Background : Transcatheter arterial chemoembolisation ( TACE ) is the treatment of choice for intermediate stage hepatocellular carcinoma ( HCC ) .  Doxorubicin-loaded drug-eluting beads (DEB)-TACE is expected to improve the performance of conventional TACE ( cTACE ) . The aim of this study was to compare DEB-TACE with cTACE in terms of time-to-tumour progression ( TTP ) , adverse events ( AEs ) , and 2-year survival . Methods : Patients were r and omised one-to-one to undergo cTACE or DEB-TACE and followed-up for at least 2 years or until death . Transcatheter arterial chemoembolisation was repeated ‘ on-dem and ’ . Results : We enrolled 177 patients : 89 underwent DEB-TACE  and 88 cTACE . The median number of procedures was 2 in each arm , and the in-hospital stay was 3 and 4 days , respectively ( P=0.323 ) . No differences were found in local and overall tumour response . The median TTP was 9 months in both arms . The AE incidence and severity did not differ between the arms , except for post-procedural pain , more frequent and severe after cTACE ( P<0.001 ) . The 1- and 2-year survival rates were 86.2 % and 56.8 % after DEB-TACE and 83.5 % and 55.4 % after cTACE ( P=0.949 ) . Eastern Cooperative Oncology Group ( ECOG ) , serum albumin , and tumour number independently predicted survival ( P<0.05 ) . Conclusions : The DEB-TACE and the cTACE are equally effective and safe , with the only advantage of DEB-TACE being less post-procedural abdominal pain The objective of this study was to evaluate the response rate and survival of hepatocellular carcinoma portal vein thrombosis ( PVT ) patients treated with 90Y-loaded glass microspheres using a personalized dosimetry and intensification concept . Methods : The microspheres were administered to 41 hepatocellular carcinoma PVT patients ( main = 12 ; lobar/segmental = 29 ) .  99mTc-macroaggregated albumin SPECT/CT quantitative analysis was used to calculate the tumor dose ( TD ) , healthy injected liver dose ( HILD ) , and injected liver dose ( ILD ) . Response was evaluated at 3 mo using the criteria of the European Association for the Study of the Liver , with CT follow-up lasting until disease progression or death . Survival was assessed using the Kaplan – Meier method . Results : The mean injected activity was 3.1 ± 1.5 GBq , and mean ILD was 143 ± 49 Gy . When a TD threshold of 205 Gy was applied , 99mTc-macroaggregated albumin SPECT/CT achieved a 100 % sensitivity and 90 % overall accuracy ( 0 false-negatives ; 4 false-positives ) in response prediction . On the basis of TD and HILD values , 37 % of patients received an intensification of the treatment ( increased injected activity with the aim of achieving a TD ≥ 205 Gy and HILD < 120 Gy , applying an ILD > 150 Gy ) . This intensification result ed in a high response rate ( 85 % ) without increased liver toxicity of grade 3 or higher ( 6 % vs. 12 % in the patients who did not receive treatment intensification ; not statistically significant ) . For the total 41  patients , median overall survival ( OS ) was 18 mo ( 95 % confidence interval , 11–25 mo ) . For patients with a TD of less than 205 Gy , median OS was 4.3 mo ( 3.7–5 mo ) , versus 18.2 mo ( 8.5–28.7 mo ) for those with a TD of 205 Gy or more ( P = 0.005 ) . Median OS was 20.9 mo for patients with a 
    Output:
    
Based on this evidence , until the results of the ongoing r and omized trials become available , radioembolization appears to be a viable treatment option for intermediate-advanced stage HCC