{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T07:50:06Z","timestamp":1789804206749,"version":"4.0.1"},"reference-count":19,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C18342\/A23390"],"award-info":[{"award-number":["C18342\/A23390"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C9380\/A18084"],"award-info":[{"award-number":["C9380\/A18084"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2022,6,1]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Hepatocellular carcinoma (HCC) deaths are rising alarmingly. Many patients are unsuitable for available therapies. Poor response rates further hamper outcomes for those that are. Selective internal radiation therapy (SIRT) offers hope, although which patients benefit over standard approaches remains unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design\/method<\/jats:title>\n                  <jats:p>As a quality\/service improvement, we audited consecutive patients treated with SIRT (2015-2020) by the Newcastle upon Tyne Hospitals National Health Service Foundation Trust HCC multidisciplinary team . Indications, Barcelona clinic liver cancer (BCLC) stage, treatment response, subsequent therapies and survival at 30 September 2021 were assessed<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fifty-one patients received SIRT. Thirty-day mortality was zero. Three months partial response, stable disease and progressive disease on imaging were 50%, 22% and 28%, respectively. Overall median survival was 21 months. There were four subgroups: (1) BCLC-B: HCC&gt;7\u2009cm too large for transarterial chemoembolisation (TACE) alone (n=21); (2) BCLC-B: HCC progressed post TACE (n=7); (3) BCLC-C: HCC with any combination of large tumour burden, branch portal vein thrombosis, non-hepatitis C virus aetiology (n=16); (4) BCLC-C: sorafenib inappropriate (n=7). In group 1, 5\/21 (23.8%) of patients were downstaged to resection, 33% received subsequent medical therapies and median survival was &gt;40 months. In BCLC-B patients treated second line (group 2), median survival was 14.2 months. In BCLC\u2013C, median survival was 20.2 months for group 3 and 4.2 months for group 4.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>SIRT outcomes for advanced HCC, often bridging patients with adverse predictive factors to subsequent surgery or medical therapies, were encouraging. A role after TACE or for BCLC-C patients requires further assessment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/flgastro-2022-102137","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T13:54:51Z","timestamp":1656597291000},"page":"45-51","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Selective internal radiation therapy (SIRT) for hepatocellular carcinoma (HCC): informing clinical practice for multidisciplinary teams in England"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct04736121","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03380130","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct04522544","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0359-9795","authenticated-orcid":false,"given":"Helen L","family":"Reeves","sequence":"first","affiliation":[{"name":"Newcastle University Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK"},{"name":"Liver Unit, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Reicher","sequence":"additional","affiliation":[{"name":"Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Priona","sequence":"additional","affiliation":[{"name":"Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek M","family":"Manas","sequence":"additional","affiliation":[{"name":"Surgery, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Littler","sequence":"additional","affiliation":[{"name":"Radiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"2025090708115346000_14.1.45.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"2025090708115346000_14.1.45.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.03.019"},{"key":"2025090708115346000_14.1.45.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.08.011"},{"key":"2025090708115346000_14.1.45.4","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1038\/s41416-021-01509-4","article-title":"Regional variations in hepatocellular carcinoma incidence, routes to diagnosis, treatment and survival in England","volume":"126","author":"Burton","year":"2022","journal-title":"Br J Cancer"},{"key":"2025090708115346000_14.1.45.5","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1329906"},{"key":"2025090708115346000_14.1.45.6","unstructured":"Reig M , Forner A , Rimola J . BCLC strategy for prognosis prediction and treatment recommendation Barcelona clinic liver cancer (BCLC) staging system. The 2022 update. J Hepatol 2021."},{"key":"2025090708115346000_14.1.45.7","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt247"},{"key":"2025090708115346000_14.1.45.8","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1016\/S1470-2045(17)30683-6","article-title":"Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma (SARAH): an open-label randomised controlled phase 3 trial","volume":"18","author":"Vilgrain","year":"2017","journal-title":"Lancet Oncol"},{"key":"2025090708115346000_14.1.45.9","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1200\/JCO.2017.76.0892","article-title":"SIRveNIB: selective internal radiation therapy versus sorafenib in Asia-Pacific patients with hepatocellular carcinoma","volume":"36","author":"Chow","year":"2018","journal-title":"J Clin Oncol"},{"key":"2025090708115346000_14.1.45.10","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1016\/j.jvir.2018.07.006","article-title":"Tumor targeting and three-dimensional voxel-based dosimetry to predict tumor response, toxicity, and survival after yttrium-90 resin microsphere radioembolization in hepatocellular carcinoma","volume":"29","author":"Allimant","year":"2018","journal-title":"J Vasc Interv Radiol"},{"key":"2025090708115346000_14.1.45.11","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S2468-1253(20)30290-9","article-title":"Personalised versus standard dosimetry approach of selective internal radiation therapy in patients with locally advanced hepatocellular carcinoma (DOSISPHERE-01): a randomised, multicentre, open-label phase 2 trial","volume":"6","author":"Garin","year":"2021","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2025090708115346000_14.1.45.12","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1002\/hep.29480","article-title":"Radioembolization for hepatocellular carcinoma: statistical confirmation of improved survival in responders by landmark analyses","volume":"67","author":"Riaz","year":"2018","journal-title":"Hepatology"},{"key":"2025090708115346000_14.1.45.13","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1002\/hep.31819","article-title":"Yttrium-90 radioembolization for the treatment of solitary, unresectable HCC: the legacy study","volume":"74","author":"Salem","year":"2021","journal-title":"Hepatology"},{"key":"2025090708115346000_14.1.45.14","unstructured":"National Institute for Health and Care Excellence (NICE) . Selective internal radiation therapies for treating hepatocellular carcinoma - Technology appraisal guidance [TA688], 2021. Available: https:\/\/www.nice.org.uk\/guidance\/ta688"},{"key":"2025090708115346000_14.1.45.15","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1007\/s00270-021-02810-8","article-title":"Comparing real world, personalized, multidisciplinary tumor board recommendations with BCLC algorithm: 321-Patient analysis","volume":"44","author":"Matsumoto","year":"2021","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2025090708115346000_14.1.45.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.06.026"},{"key":"2025090708115346000_14.1.45.17","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1247132"},{"key":"2025090708115346000_14.1.45.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.09.026"},{"key":"2025090708115346000_14.1.45.19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1915745"}],"container-title":["Frontline Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/flgastro-2022-102137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T15:12:07Z","timestamp":1757257927000},"score":1,"resource":{"primary":{"URL":"https:\/\/fg.bmj.com\/lookup\/doi\/10.1136\/flgastro-2022-102137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,30]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12,7]]},"published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1136\/flgastro-2022-102137"],"URL":"https:\/\/doi.org\/10.1136\/flgastro-2022-102137","relation":{},"ISSN":["2041-4137","2041-4145"],"issn-type":[{"value":"2041-4137","type":"print"},{"value":"2041-4145","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,30]]}}}