Selective Internal Radiation Therapy (SIRT) Versus Transarterial Chemoembolisation (TACE) for the Treatment of Hepatocellular Carcinoma (HCC).
Inclusion Criteria:
- ≥18 years
- HCC, proven by histology or according to EASL criteria
- Intermediate stage HCC (stage B according to BCLC)
- At least one measurable lesion in magnetic resonance imaging (MRI)
- Tumor load ≤ 50%
- preserved liver function (Child Pugh A and B)
- ECOG performance status ≤2
Exclusion Criteria:
- Patients feasible for curative treatment (e.g. resection or local ablation)
- Previous TACE or SIRT
- Chemotherapy during the last 4 weeks
- Child Pugh stage C
- BCLC stage D
- ECOG Performance Status >2
- Tumor involvement >50% of the liver
- Extrahepatic tumor
- Serum Bilirubin >2.0 mg/dl; Serum Albumin 2.8 g/dl, Serum Creatinine >2 mg/dl;
Leukocytes <3000/ml; Thrombocytes <50000/ml
- Clinically apparent ascites (ascites only in CT/MRI is no exclusion criteria)
- Esophageal bleeding during the last 3 months
- Hepatic encephalopathy
- Transjugular intrahepatic portosystemic shunt (TIPS)
- Infiltration or occlusion of the main portal vein
- Hepatofugal blood flow in the portal vein
- Hepatopulmonary shunt ≥ 20% in the macroaggregated albumin scan
- Contraindications against angiography
- Gravidity