Same-Day Yttrium-90 Radioembolization: Feasibility with Resin Microspheres

Autor: Omar Zurkiya, Matthew D. Li, Eric Wehrenberg-Klee, Raymond W. Liu, Vincent Wu, Katrina F. Chu, Allegra Depietro, Suvranu Ganguli
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
Carcinoma
Hepatocellular
Time Factors
medicine.medical_treatment
Clinical Decision-Making
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
medicine
Carcinoma
Humans
Radiology
Nuclear Medicine and imaging
Yttrium Radioisotopes
Embolization
Adverse effect
Aged
Retrospective Studies
Body surface area
Aged
80 and over
medicine.diagnostic_test
business.industry
Patient Selection
Liver Neoplasms
Common Terminology Criteria for Adverse Events
Middle Aged
medicine.disease
Embolization
Therapeutic
Microspheres
Treatment Outcome
Response Evaluation Criteria in Solid Tumors
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Angiography
Feasibility Studies
Female
Radiology
Radiopharmaceuticals
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of vascular and interventional radiology : JVIR. 30(3)
ISSN: 1535-7732
Popis: Purpose To evaluate the feasibility of a same-day yttrium-90 (90Y) radioembolization protocol with resin microspheres (including pretreatment angiography, lung shunt fraction [LSF] determination, and radioembolization) for the treatment of hepatocellular carcinoma (HCC) and liver metastases. Materials and Methods All same-day radioembolization procedures performed over 1 y (February 2017 to January 2018) were included in this single-institutional retrospective analysis, in which 34 procedures were performed in 26 patients (median age, 63 y; 13 women), 19 with liver metastases and 7 with HCC. Yttrium-90 treatment activities were calculated by body surface area method. Tumor imaging response was assessed by Response Evaluation Criteria In Solid Tumors (RECIST) 1.1 for liver metastases and modified RECIST for HCC. Clinical side effects and adverse events were graded per Common Terminology Criteria for Adverse Events version 4.0. Results All planned cases were technically successful, and no cases were canceled for elevated LSF or vascular anatomic reasons. Pretreatment angiography modified the planned 90Y treatment activity in 1 case in which vascular anatomy required a lobar-dose split into 2 for segmental infusions. In 18% of cases, patients were briefly admitted after the procedure for observation or symptom management. Imaging evaluation of initial efficacy at 1 month demonstrated partial response in 25% and stable disease in 67% of patients with liver metastases and partial/complete response in 43% and stable disease in 14% of patients with HCC. Grade ≥ 3 adverse events occurred in 6% of cases, with no systemic therapy–limiting toxicities. The mean total procedure time was 4.2 hours. Conclusions A same-day 90Y radioembolization protocol with resin microspheres is feasible in select patients, which can expedite cancer therapy.
Databáze: OpenAIRE
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