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Advances in Radiotherapy
& Nuclear Medicine SIR-spheres Y-90 resin microspheres for HCC treatment

At the time of treatment, one patient received prior using SIRT in Vietnam. Our data also indicate that the
sorafenib, and another received prior chemotherapy. Most use of SIRT provides additional benefits to patients with
patients utilized concomitant systemic therapy during the unresectable HCC.
study, with the most common drug being an herbal liver
tonic. It is worth noting that since the closing of this study, the Acknowledgments
IMBRAVE-150 trial has demonstrated that the programmed The authors thank Kristina Wasson-Blader, Ph.D., ELS,
death-ligand 1 inhibitor, atezolizumab, in conjunction and Alison Chantal Caviness, MD, Ph.D., of Eubio Medical
with bevacizumab, conferred a survival benefit superior to Communications, for medical writing assistance.
sorafenib monotherapy in patients with first-line unresectable
HCC . Atezolizumab is now available in Vietnam but is Funding
[21]
expensive and not covered by Vietnam’s health insurance, This study was supported by SIRTEX company.
thus limiting access to this new treatment method for many
patients and, subsequently, its effect on the current indication Conflict of interest
for SIRT in patients with unresectable HCC.
The authors declare no competing of interest.
Abdominal pain, vomiting, and nausea were the
frequently reported AEs by our patients, similar to those Author contributions
reported by other studies; however, fatigue was only Conceptualization: Khoa Mai Trong, Bang Mai Hong
reported by one patient in our study, while it was commonly Investigation: Duy Anh Nguyen, Hai Binh Tran, Luu Vu
reported in other studies [9,22-26] . Mantry et al. also reported Dang, Chau Ha Trinh, Thinh Nguyen Tien, Phuong
18.9% of patients had ascites at 3 months after SIRT, and Pham Cam, Thai Pham Van, Ky Doan Thai, Thong
7.5% had GI bleeding . Pham Minh,
[25]
Furthermore, we did not detect any clinically meaningful Writing–original draft: Anh Nguyen Duy, Binh Hai Tran,
trends or patterns of change in liver function parameters Phuong Pham Cam, Khoa Mai Trong, Thai Pham Van
after SIRT, which may be reflective of the general health Writing–review & editing: Phuong Pham Cam, Anh
status of the liver for our patients. AFP levels decreased Nguyen Duy, Khoa Mai Trong.
by a clinically significant amount over 6 months, but the
difference was not statistically significant, likely due to the Ethics approval and consent to participate
small sample size. This study was approved by Ethics Committee of the
Most AEs reported by our patients were mild to moderate, Ministry of Health of Vietnam (certificate of approval
and no SIRT-related SAEs were reported. The pattern of No. 59/CN-BDGĐĐ).
SAEs was reflective of the patient population with underlying Consent for publication
disease and comorbidities. Importantly, no new safety
concerns were identified. Thus, our study demonstrated a All patients provided written informed consent before
lack of meaningful toxicity resulting from SIRT. enrollment.
Our study has several limitations. While the patient Availability of data
data were collected prospectively, we were able to only
enroll 30 patients, and therefore, our study was not Not applicable.
powered to identify prognostic or predictive factors for References
SIRT responses. In addition, the small sample size may
have precluded the identification of clinically significant 1. Bray F, Ferlay J, Soerjomataram I, et al., 2018, Global cancer
trends in laboratory values; however, enrollment was statistics 2018: GLOBOCAN estimates of incidence and
restricted to patients with good liver function. Compared mortality worldwide for 36 cancers in 185 countries. CA
with the traditional method (TACE), we found that the Cancer J Clin, 68: 394–424.
medical expense of SIRT is higher, and the side effects are https://doi.org/10.3322/caac.21492
minor, especially for abdominal pain and fever after the 2. World Health Organization. Vietnam Cancer Country
intervention. Profile 2020. Geneva: World Health Organization. Available
from: https://www.who.int/publications/m/item/cancer-
5. Conclusion vnm-2020 [Last accessed on 2020 Feb 28].

In this observational study, we provide evidence indicating 3. Nguyen-Dinh SH, Do A, Pham TND, et al., 2018, High
the low risk of treating patients with unresectable HCC burden of hepatocellular carcinoma and viral hepatitis in

Volume 1 Issue 1 (2023) 7 https://doi.org/10.36922/arnm.0385