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World J Gastrointest Oncol. Jul 15, 2025; 17(7): 109379
Published online Jul 15, 2025. doi: 10.4251/wjgo.v17.i7.109379
Yttrium-90 microsphere therapy for hepatocellular carcinoma: Clinical efficacy, mechanistic insights, and comparative therapeutic perspectives
Yu-Hang Zhu, Ming-Wei Wang, Yan Jiao, Ya-Hui Liu, Shan-Shan Dong
Yu-Hang Zhu, Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin Province, China
Ming-Wei Wang, Ministry of Health Key Laboratory of Radiobiology, School of Public Health of Jilin University, Changchun 130000, Jilin Province, China
Yan Jiao, Ya-Hui Liu, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Shan-Shan Dong, Department of Anesthesiology, The Second Hospital of Jilin University, Changchun 130022, Jilin Province, China
Co-corresponding authors: Ya-Hui Liu and Shan-Shan Dong.
Author contributions: Zhu YH contributed to the writing, editing of the manuscript and table; Jiao Y contributed to the discussion and design of the manuscript; Wang MW contributed to the literature search; Liu YH and Dong SS designed the overall concept and outline of the manuscript; All authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Hui Liu, MD, Doctor, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Xinmin Street, Changchun 130021, Jilin Province, China. yahui@jlu.edu.cn
Received: May 9, 2025
Revised: May 19, 2025
Accepted: June 6, 2025
Published online: July 15, 2025
Processing time: 67 Days and 2.2 Hours
Abstract

Yttrium-90 (Y-90) microsphere therapy, known as radioembolization, has emerged as a pivotal treatment modality for hepatocellular carcinoma (HCC), delivering targeted radiation with minimal collateral damage to healthy liver tissues. This review meticulously synthesizes current evidence regarding the clinical efficacy, underlying therapeutic mechanisms, patient selection criteria, and comparative advantages of Y-90 therapy. Clinical studies consistently demonstrate significant improvements in overall survival and progression-free survival, coupled with robust tumor response rates and manageable adverse events. The therapy’s efficacy is substantially enhanced by advanced dosimetric techniques, enabling precise radiation delivery tailored to individual tumor profiles. Comparative analyses reveal that Y-90 therapy provides superior local tumor control and a preferable safety profile compared to conventional treatments such as transarterial chemoembolization and external beam radiation therapy. Additionally, its clinical outcomes are comparable to those achieved with contemporary systemic therapies. Ongoing research into combination treatments incorporating Y-90 with systemic therapies, including targeted agents and immune checkpoint inhibitors, suggests promising advancements in comprehensive HCC management. Future directions highlight the necessity for continued refinement of dosimetry and patient stratification approaches, aiming to further optimize therapeutic outcomes.

Keywords: Hepatocellular carcinoma; Yttrium-90 microsphere therapy; Radioembolization; Dosimetry; Clinical outcomes; Comparative efficacy

Core Tip: Yttrium-90 (Y-90) microsphere therapy effectively prolongs overall survival and progression-free survival in hepatocellular carcinoma patients, demonstrating excellent tumor response rates and minimal severe adverse events. Advanced dosimetry and integration with systemic therapies further enhance its efficacy. Compared to conventional treatments, Y-90 offers improved local tumor control and better safety, marking it a pivotal component in contemporary multimodal cancer management.