零关税Y-90微球：乐城医院肝癌治疗的新希望

Recently, three liver cancer patients successfully underwent Yttrium-90 (Y-90) glass microsphere treatment at the Ruijin Hospital Hainan Hospital (Ruijin Hainan Hospital) affiliated with Shanghai Jiao Tong University School of Medicine, located in the Boao Lecheng International Medical Tourism Pilot Zone in Hainan. This marks the first time that Y-90 glass microsphere treatments have been performed under Hainan Free Trade Port’s “zero-tariff” policy. The implementation of this policy has directly reduced the treatment cost of the medical device by RMB 50,000 per patient, signaling a significant step forward in improving both the accessibility and affordability of advanced international oncology therapies in Lecheng.

Inside the operating room, Dr. Wang Zhongmin, Chief Interventional Radiologist at Ruijin Hospital Shanghai, stood at the console, his expression focused and steady as the regular beeping of the monitors filled the room. As he carefully withdrew the last microcatheter, he let out a quiet breath—the procedure had gone smoothly.

Among the first patients to benefit from the “zero-tariff” Y-90 glass microspheres, two had traveled from Shanghai specifically to be treated by Dr. Wang. One of them had primary liver cancer with a massive tumor in the right lobe, richly vascularized and inoperable by conventional surgical resection. “We hope that Y-90 therapy can serve as a bridge to downstage the tumor, and eventually create an opportunity for surgical resection,” Dr. Wang explained.

The second patient from Shanghai presented an even more complex challenge. Dr. Wang noted that this patient had already undergone multiple interventional treatments, combined with targeted therapy and chemotherapy, all with poor results—a typical case of advanced, multi-treated hepatocellular carcinoma. Repeated treatments had led to extremely poor vascular conditions and complex anatomy. Because the tumor was located in the left lobe and fed by multiple aberrant arterial branches, the team performed superselective catheterization one by one, ensuring that the microspheres entered only the tumor-feeding vessels while sparing healthy liver tissue. The procedure was akin to navigating a dense spiderweb of blood vessels with millimeter precision. “For patients with unresectable liver cancer, Y-90 offers a new pathway,” said Dr. Wang.

The third case was a local patient from Hainan, operated on by Dr. Lin Fuhuang, Chief of Interventional Radiology at Hainan General Hospital. The patient was diagnosed with primary liver cancer after being admitted with fever—the tumor measured up to 14 cm in diameter, a giant hepatocellular carcinoma that precluded conventional surgical options. Dr. Lin explained that Y-90 glass microsphere therapy is a form of selective internal radiation therapy that delivers radioactive microspheres directly into the tumor via an interventional approach, releasing high-energy beta rays to precisely kill cancer cells. This could potentially create a window for surgical resection or liver transplantation.

Y-90 glass microsphere therapy is the world’s first FDA‑approved microsphere technology for primary liver cancer, and has been used clinically in over 50 countries and regions for more than 20 years. It is often described as the “nuclear weapon” of interventional oncology for liver cancer.

Y-90 is a radioactive isotope with a half‑life of just 64 hours. Its beta radiation is high‑energy but has a very short tissue penetration depth—on average only 2.5 millimeters. Scientists encapsulate Y‑90 inside glass microspheres measuring just 20–30 micrometers in diameter—about one‑third the width of a human hair. Through a minimally invasive interventional procedure, the physician delivers millions of microspheres directly into the blood vessels feeding the liver tumor. The microspheres become lodged in the tumor’s capillary network and continuously emit beta radiation from within, acting like a “precision detonation” that kills cancer cells efficiently while sparing surrounding healthy liver tissue and adjacent organs, thanks to the shallow penetration depth of just 2.5 mm.

The entire treatment does not require open surgery. The physician makes a tiny incision—about the size of a pencil tip—in the femoral artery of the groin or the radial artery of the wrist, advances a microcatheter under DSA imaging to the hepatic artery branch supplying the tumor, and then slowly injects the Y‑90 microspheres. The microspheres are carried by the blood flow and become selectively trapped in the tumor’s capillary bed. The procedure typically takes about one hour, and patients are usually discharged after 1–2 days of observation.

Y-90 glass microsphere therapy is primarily indicated for unresectable liver cancer, including both hepatocellular carcinoma and metastatic liver cancer, and can also be used in patients with portal vein tumor thrombosis. It effectively shrinks tumors, enabling previously inoperable patients to become candidates for curative resection, or serves as a bridge to liver transplantation.

Because Y‑90 glass microspheres are radioactive pharmaceuticals with a half‑life of only 64 hours, logistics and customs clearance present an extraordinary challenge. “The product must move seamlessly from production to administration,” explained Peng Sinan, Customs Manager at the Boao Public Bonded Warehouse. “If the international shipping, customs clearance, warehousing, and delivery to the hospital cannot be completed within a very tight timeframe, the potency will be greatly reduced or even lost.”

To ensure the safe and timely arrival of this special imported medical device, the Lecheng bonded warehouse team began preparing well in advance—completing system entries, document reviews, and airport pickup arrangements before the cargo even left the country of origin. When the shipment landed in Hainan, the waiting team immediately processed customs clearance, transport, and acceptance inspection. “From the moment the goods arrived in Hainan to customs declaration, inspection, and delivery to the hospital, the entire process took only half a day,” Peng Sinan said with pride.

While the technology is advanced, cost has been a major barrier preventing broader patient access. Imported Y‑90 microspheres carry high tariffs and logistics expenses, making treatment expensive. That situation is now beginning to change.

Under the “Zero‑Tariff Policy for Drugs and Medical Devices in Hainan Free Trade Port,” jointly issued by the Ministry of Finance, the National Health Commission, the General Administration of Customs, the State Taxation Administration, and the National Medical Products Administration, qualified medical institutions registered and operating in the Boao Lecheng Pilot Zone can import eligible pharmaceuticals and medical devices free of import tariffs, import value‑added tax, and consumption tax. This policy has been operating smoothly since its first implementation on December 31, 2024.

Dr. Jin Jiabin, Vice President of Ruijin Hainan Hospital, noted that the high cost of Y‑90 glass microspheres had previously deterred many patients. “Thanks to the implementation of Hainan Free Trade Port’s zero‑tariff policy, each patient now saves RMB 50,000 in tax costs,” Dr. Jin said. “Our hospital passes that full saving directly on to patients.”

On the insurance front, Y‑90 glass microsphere therapy has been included in Lecheng’s Global Special Drug Insurance as well as certain city‑based supplemental health insurance plans (Huiminbao). In some cases, reimbursement rates can reach 80%, meaning that with the zero‑tariff benefit combined with insurance coverage, out‑of‑pocket costs for patients will be further reduced.

Since the first Y‑90 procedure was performed in Lecheng in May 2024, nearly 100 liver cancer patients have received this therapy at the pilot zone, with overall outcomes proving highly effective. With the zero‑tariff policy now in effect and insurance coverage continuing to expand, this international innovation is expected to become more widely accessible across the Lecheng Pilot Zone.