Post by Zachary Berman

👋 I wanted to try something new to help with education. I have started doing informational videos based on important papers. Let me know what you think! 🤔 I review the PROACTIF paper and its practical implications here: https://lnkd.in/g_hJPQFF PROACTIF, the largest prospective real-world study of Y90 glass microspheres for hepatocellular carcinoma. This multicenter cohort included 989 patients across 34 French centers and provides an important look at how personalized, dosimetry-guided radioembolization performs outside of a highly selected randomized-trial population. A few findings I found particularly relevant: • Median overall survival was 21.8 months overall, including 21.1 months in BCLC C disease. • Higher index-lesion absorbed dose was associated with better survival, with median OS of 30.7 months at ≥400 Gy versus 16.8 months below 200 Gy. • Carefully selected patients with Vp1–Vp2 portal vein tumor thrombosis had outcomes comparable to those without PVT. • More than 10% of patients subsequently underwent transplant or resection, emphasizing the importance of repeated multidisciplinary reassessment after treatment. The study reinforces several practical themes: personalized dosimetry should be central to treatment planning, low-extent PVT should not be an automatic exclusion criterion, selective treatment is valuable when anatomically feasible, and Y90 can support downstaging pathways—not just local disease control. #HCC #HepatocellularCarcinoma #Radioembolization #Y90 #InterventionalRadiology #InterventionalOncology #Dosimetry #LiverCancer