A Treatment of Unresectable Hepatocellular Carcinoma With TheraSphere (Yttrium-90 Glass Microspheres): A HDE Treatment Use Protocol

Inclusion Criteria:

- Confirmed diagnosis of hepatocellular carcinoma

- Surgical evaluation by a member of the Liver Tumor Program must conclude the patient
is not a candidate for resection or ablation

- Eastern Cooperative Oncology Group (ECOG) Performance Status Score 0-2

- Able to comprehend and provide written informed consent in accordance with
institutional and federal guidelines

Exclusion Criteria:

- Absolute granulocyte count =<1,500/ul

- Platelet count =<75,000/ul

- Serum creatinine >= 2.0 mg/dl

- Serum bilirubin * >= 2.0 mg/dl for bilateral treatment or lobar treatment * > 3.0
mg/dl for single lesion which could be treated by segmental fusion

- History of severe allergy or intolerance to any contrast media, narcotics, sedatives,
or atropine

- Bleeding, diathesis not correctable by usual forms of therapy

- Severe peripheral vascular disease that would preclude catheterization

- Portal hypertension with portal venous shunt away from the liver

- Evidence of potential delivery greater than 16.5 mCi (30 Gy absorbed dose) of
radiation to the lungs on either: 1) first TheraSphere administration; or 2)
cumulative delivery of radiation to the lungs > 30 Gy over multiple treatments

- Evidence of any detectable Tc-99m MMA flow to the stomach or duodenum, after
application of established angiographic techniques to stop such flow

- Significant extrahepatic disease representing an imminent life-threatening outcome

- Severe liver dysfunction (Childs' Classification C) or pulmonary insufficiency
(requiring continuous oxygen therapy)

- Active uncontrolled infection

- Significant underlying medical or psychiatric illness

- Pregnant women may not participate

- Children may not participate