ArticleHepatology communications2026
Radioembolization (90Y) achieves higher response rates and reduces progression risk compared with DEB-TACE in hepatocellular carcinoma.
Article in Hepatology communications, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDrug-eluting bead transarterial chemoembolization (DEB-TACE) and yttrium-90 (90Y) radioembolization are approved therapies to treat hepatocellular carcinoma (HCC). Several randomized controlled trials and propensity score-matched studies (PSM) have been conducted to compare these 2 treatments; many utilized 90Y standard dosimetry (<200 Gy), which produced inferior outcomes compared with modern-day 90Y personalized dosimetry, which yields tumor doses exceeding 205 Gy. PURPOSE: This study utilized PSM between DEB-TACE and 90Y with personalized dosimetry to compare treatment and patient outcomes in Barcelona Clinic Liver Cancer (BCLC) A-B HCC.
methodsThis retrospective study included 258 patients with unresectable BCLC A-B stage HCC treated with DEB-TACE or 90Y as the initial treatment approach from 2015 to 2024. PSM was performed (90Y:DEB-TACE), matching for tumor burden and alpha-fetoprotein levels at diagnosis. The primary endpoint was target response rate with secondary endpoints of overall response, target retreatment rate (TTR), target and overall time-to-progression (TTP), and overall survival (OS).
resultsOverall, 90Y achieved significantly higher target complete (CR) and objective response (OR) rates compared with DEB-TACE (71% vs. 33% and 88% vs. 58%), respectively. In multifocal disease, target CR rates were higher following 90Y (68% vs. 13%). 90Y also yielded a longer duration of CR with a 1-year target retreatment rate of 12% compared with 40% with DEB-TACE. This translated into a longer target TPP (p=0.030) with 90Y, although overall TPP and OS were similar between treatment modalities. In multifocal disease, 90Y generated superior response rates as well as target (p=0.007) and overall TTP (p=0.015).
conclusions90Y with personalized dosimetry achieved higher response rates and extended the duration of complete responses compared with DEB-TACE. 90Y was also more effective at treating multifocal disease.
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