ArticleHepatology (Baltimore, Md.)2021
Yttrium-90 Radioembolization for the Treatment of Solitary, Unresectable HCC: The LEGACY Study.
Article in Hepatology (Baltimore, Md.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07586046 (A Prospective Dose-Escalation Study to Define an Ablative Dose of Yttrium-90 Transarterial Radioembolization Using Advanced Dosimetry and Functional MRI), which is not on this map. Cited by 294 papers, 5 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Prospective Dose-Escalation Study to Define an Ablative Dose of Yttrium-90 Transarterial Radioembolization Using Advanced Dosimetry and Functional MRI (MARGIN Study)
Who cites it
294 citing papers in PubMed, 5 syntheses or guidelines pooled it, 479 citations in OpenAlex.
- Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment, and follow-up of patients with hepatocellular carcinoma.ESMO open · 2026Guideline
- Pooled it
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- Respiratory adverse effects in patients treated with immune checkpoint inhibitors in combination with radiotherapy: a systematic review and meta-analysis.Radiation oncology (London, England) · 2024Pooled it
- Guideline
- Microbubble-based Radiosensitization of Hepatocellular Carcinoma: Evaluation of Safety and Efficacy in a Phase II Randomized Trial.Radiology · 2025Trial
- Adjuvant holmium-166 radioembolization after radiofrequency ablation in early-stage hepatocellular carcinoma patients: a dose-finding study (HORA EST HCC trial).European journal of nuclear medicine and molecular imaging · 2024Trial
- Long-Term Overall Survival After Selective Internal Radiation Therapy for Locally Advanced Hepatocellular Carcinomas: Updated Analysis of DOSISPHERE-01 Trial.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2024Trial
- Treatment patterns and outcomes in US patients with unresectable HCC treated with embolization.Hepatic oncology · 2026Article
- Recent developments and prospects in locoregional therapy of hepatocellular carcinoma.Abdominal radiology (New York) · 2026Review
- Systemic treatment paradigms for unresectable and advanced hepatocellular carcinoma in Europe.The Lancet regional health. Europe · 2026Review
- Cost Analysis of Percutaneous Segmentectomy Versus Chemoembolisation and Radioembolisation in Hepatocellular Carcinoma: A Retrospective Multicentre Cohort Study.Cardiovascular and interventional radiology · 2026Article
- Sequential transarterial radioembolization and atezolizumab plus bevacizumab improves survival in advanced hepatocellular carcinoma.European radiology · 2026Article
- Radiation segmentectomy for hepatocellular carcinoma: redefining the limits of curative-intent therapy.The British journal of radiology · 2026Review
- A novel approach to radioembolization treatment planning using a hybrid [European journal of nuclear medicine and molecular imaging · 2026Article
- Elevated baseline C-reactive protein is associated with treatment failure and shorter survival after Yttrium-90 radioembolization in hepatocellular carcinoma.Annals of nuclear medicine · 2026Article
- Review
- Interventional strategies for inferior phrenic artery management in yttrium‑90 selective internal radiation therapy for hepatocellular carcinoma: A single‑center retrospective study.European journal of nuclear medicine and molecular imaging · 2026Article
- A comprehensive review on the current applications and future perspectives of radioembolization in endovascular neurosurgery.Journal of neurointerventional surgery · 2026Review
- Case 25: A 37-Year-Old Woman With Fanconi Anemia and a Hepatic Mass.Journal of Korean medical science · 2026Article
234 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsLocoregional therapies, including yttrium-90 radioembolization, play an important role in the treatment of unresectable HCC. The aim of the LEGACY (Local radioEmbolization using Glass Microspheres for the Assessment of Tumor Control with Y-90) study was to evaluate objective response rate (ORR) and duration of response (DoR) in patients with solitary unresectable HCC treated with yttrium-90 glass microspheres. APPROACH AND
resultsLEGACY is a multicenter, single-arm, retrospective study conducted at three sites that included all eligible, consecutive patients with HCC treated with radioembolization between 2014 and 2017. Eligibility criteria included solitary HCC ≤ 8 cm, Child-Pugh A cirrhosis, and Eastern Cooperative Oncology Group performance status 0-1. Primary endpoints were ORR and DoR based on modified Response Evaluation Criteria in Solid Tumors in the treated area (localized), as evaluated by blinded, independent, central review. Radioembolization was performed with intent of ablative-level dosimetry in a selective fashion when possible. Overall survival was evaluated using Kaplan-Meier and multivariate Cox proportional hazards. Among the 162 patients included, 60.5% were Eastern Cooperative Oncology Group 0, and the median tumor size was 2.7 cm (range: 1-8) according to blinded, independent, central review. Radioembolization served as neoadjuvant therapy for transplantation or resection in 21.0% (34 of 162) and 6.8% (11 of 162) of patients, respectively, and as primary treatment for all others. Median follow-up time was 29.9 months by reverse Kaplan-Meier. ORR (best response) was 88.3% (CI: 82.4-92.4), with 62.2% (CI: 54.1-69.8) exhibiting a DoR ≥ 6 months. Three-year overall survival was 86.6% for all patients and 92.8% for those neoadjuvant patients with resected or transplanted liver.
conclusionsIn this multicenter study of radioembolization, clinical meaningful response rates and prolonged DoR were observed in the treatment of unresectable, solitary HCC ≤ 8 cm.
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