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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