Selective Internal Radiation Therapy Approval for Early HCC: What Comes Next?

Selective internal radiation therapy (SIRT) using with Yttrium 90 (Y90) loaded microspheres (also called radioembolization) was introduced long ago for the treatment of hepatocellular carcinoma (HCC). Despite numerous reports of activity across tumor stages, the absence of positive randomized clinical trials has delayed or prevented SIRT from being strongly recommended or recommended at all in many scientific guidelines. Over the years, technical improvements, procedural standardization and a better patient selection have improved the results of SIRT, and many centers have become experienced to an extent where SIRT may not be considered an experimental therapy.