Selective Internal Radiation Therapy and 188Re-SSS Lipiodol Treatment for Liver Cancer (Lip-Re2)

Prior treatment

• Previous SIRT
• Previous systemic treatment within 4 weeks before radioembolization
• More than 2 previous TACE (or embolization), in the area to be treated

Other illness

• Chronic respiratory insufficiency history

Lab values

• Inadequate hematological, hepatic, renal, thyroid and coagulation functions:
  • Hemoglobin < 8,5 g/dl
  • Granulocytes < 1500/mm3
  • Platelets< 50 000 /mm3
  • Bilirubin level ≥ 35 mol/l
  • Transaminases > 6 UNL
  • Creatinine > 1,5 UNL
  • TSH < 0,2 µUI/L
• Lung shunt >20% evaluated with 99mTc albumin macroaggregate (MAA)
• Poor tumor targeting with 99mTc albumin macroaggregate (MAA)

Other

• Known hemophilia with exophytic tumor > 1 cm
• Extra-hepatic metastasis except hilum node < 2 cm
• Other neoplasia except if complete remission from at least one year
• Contraindication related to the technique, in particular severe arterial pathology of the lower limbs or the aorta contraindicating or making difficult an arteriography by femoral approach
• Pregnant woman or likely to be or breastfeeding, or male or female patients of reproductive potential without effective contraception from screening to 1 month after the end of the treatment
• Minors, individual deprived of liberty, or under any kind of guardianship or trusteeship.
• Patients unable to submit to medical follow-up of the study for social, medical or psychological reasons.

• Age ≥ 18
• ECOG Performance Status 0-1
• HCC with histological diagnosis or non-invasive diagnosis according to AASLD criteria
• Non operable and not accessible to ablation therapy
• At least one measurable lesion using mRECIST
• Tumor involvement <50% of the liver
• BCLC classification A to C
• Compensated cirrhosis (Child Pugh A or B7), if cirrhosis present
• Registration with a social security scheme
• Written and informed consent of the patient or his/her legal representative