| 8 | Sequential tumor-directed and lobar radioembolization before major hepatectomy for hepatocellular carcinoma显示文摘Preoperative radioembolization may improve the resectability of liver tumor by inducing tumor shrinkage, atrophy of the embolized liver and compensatory hypertrophy of non-embolized liver. We describe the case of a cirrhotic Child-Pugh A patient with a segment Ⅳ hepatocellular carcinoma requiring a left hepatectomy. Preoperative angiography demonstrated 2 separated left hepatic arteries, for segment Ⅳ and segments Ⅱ-Ⅲ. This anatomic variant allowed sequential radioembolizations, delivering high-dose ^(90)Yttrium(160 Gy) to the tumor, followed 28 d later by lower dose(120 Gy) to segments Ⅱ-Ⅲ. After 3 mo, significant tumor response and atrophy of the future resected liver were obtained, allowing uneventful left hepatectomy. This case illustrates that, when anatomic disposition permits it, sequential radioembolizations, delivering different ^(90)Yttrium doses to the tumor and the future resected liver, could represent a new strategy to prepare major hepatectomy in cirrhotic patients, allowing optimal tumoricidal effect while reducing the toxicity of the global procedure. | Michael Vouche Thierry Degrez Fikri Bouazza Philippe Delatte Maria Gomez Galdon Alain Hendlisz Patrick Flamen Vincent Donckier | 2017 | World Journal of Hepatology2017，9，36： | 0 |
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