Title: Efficacy and safety of selective internal radiation therapy with yttrium-90 for the treatment
of unresectable hepatocellular carcinoma
Version: 2 Date: 27 Feb 2021
Reviewer:  Andrea Chierici
Reviewer's report:
Dear author,
I really appreciate your manuscript that deals with a topic which is of central importance in the
treatment of non-surgical HCC. I think the topic is really interesting, and the contents of the paper
are pretty well structured. Nevertheless, some points of the study deserve further clarification
as I pointed out in the dedicated revision area. Moreover, I would be happy if the authors could
discuss the following concerns:
- although it is quite clear at first sight, the limitations of this manuscript should be presented,
with particular attention to the retrospective nature of the study and the quite limited follow-up
- the presence of a high percentage of patients for whom the tumor response could not be
evaluated is another limitation for the results of the study. Moreover, I found it not clear what
expressed in lines 17-18-19: are those 31 patients part of the "more than 6 months follow-up"
group or not?;
- in the discussion, I suggest citing the meta-analysis from Rognoni et al. [1] and from
Facciorusso et al. [2] which represent some very effective publications on this topic, in line with
your results on radiation therapy and its comparison with TACE.
1.  Rognoni C, Ciani O, Sommariva S, et al. Trans-arterial radioembolization in intermediate-
advanced hepatocellular carcinoma: Systematic review and meta-analyses. Oncotarget.
2016;7(44):72343-72355. doi:10.18632/oncotarget.11644
2.  Facciorusso A, Muscatiello N, Serviddio G. Transarterial radioembolization vs
chemoembolization for hepatocarcinoma patients: A systematic review and metaanalysis. World
J Hepatol. 2016;8(18):770-778. doi:10.4254/wjh.v8.i18.770
Title: Efficacy and safety of selective internal radiation therapy with yttrium-90 for the treatment
of unresectable hepatocellular carcinoma
Version: 2 Date: 27 Feb 2021
Reviewer:  Andrea Chierici
Reviewer's report:
Dear author,
I really appreciate your manuscript that deals with a topic which is of central importance in the
treatment of non-surgical HCC. I think the topic is really interesting, and the contents of the paper
are pretty well structured. Nevertheless, some points of the study deserve further clarification
as I pointed out in the dedicated revision area. Moreover, I would be happy if the authors could
discuss the following concerns:
- although it is quite clear at first sight, the limitations of this manuscript should be presented,
with particular attention to the retrospective nature of the study and the quite limited follow-up
- the presence of a high percentage of patients for whom the tumor response could not be
evaluated is another limitation for the results of the study. Moreover, I found it not clear what
expressed in lines 17-18-19: are those 31 patients part of the "more than 6 months follow-up"
group or not?;
- in the discussion, I suggest citing the meta-analysis from Rognoni et al. [1] and from
Facciorusso et al. [2] which represent some very effective publications on this topic, in line with
your results on radiation therapy and its comparison with TACE.
1.  Rognoni C, Ciani O, Sommariva S, et al. Trans-arterial radioembolization in intermediate-
advanced hepatocellular carcinoma: Systematic review and meta-analyses. Oncotarget.
2016;7(44):72343-72355. doi:10.18632/oncotarget.11644
2.  Facciorusso A, Muscatiello N, Serviddio G. Transarterial radioembolization vs
chemoembolization for hepatocarcinoma patients: A systematic review and metaanalysis. World
J Hepatol. 2016;8(18):770-778. doi:10.4254/wjh.v8.i18.770
Please review this paper.
user
Title: Efficacy and safety of selective internal radiation therapy with yttrium-90 for the treatment
of unresectable hepatocellular carcinoma
Version: 2 Date: 27 Feb 2021
Reviewer:  Andrea Chierici
Reviewer's report:
Dear author,
I really appreciate your manuscript that deals with a topic which is of central importance in the
treatment of non-surgical HCC. I think the topic is really interesting, and the contents of the paper
are pretty well structured. Nevertheless, some points of the study deserve further clarification
as I pointed out in the dedicated revision area. Moreover, I would be happy if the authors could
discuss the following concerns:
- although it is quite clear at first sight, the limitations of this manuscript should be presented,
with particular attention to the retrospective nature of the study and the quite limited follow-up
- the presence of a high percentage of patients for whom the tumor response could not be
evaluated is another limitation for the results of the study. Moreover, I found it not clear what
expressed in lines 17-18-19: are those 31 patients part of the "more than 6 months follow-up"
group or not?;
- in the discussion, I suggest citing the meta-analysis from Rognoni et al. [1] and from
Facciorusso et al. [2] which represent some very effective publications on this topic, in line with
your results on radiation therapy and its comparison with TACE.
1.  Rognoni C, Ciani O, Sommariva S, et al. Trans-arterial radioembolization in intermediate-
advanced hepatocellular carcinoma: Systematic review and meta-analyses. Oncotarget.
2016;7(44):72343-72355. doi:10.18632/oncotarget.11644
2.  Facciorusso A, Muscatiello N, Serviddio G. Transarterial radioembolization vs
chemoembolization for hepatocarcinoma patients: A systematic review and metaanalysis. World
J Hepatol. 2016;8(18):770-778. doi:10.4254/wjh.v8.i18.770
assistant