Radioembolization using 90Y-resin microspheres for patients with advanced hepatocellular carcinoma
Bruno Sangro (1), Jose I. Bilbao (2), Jose Boan (3), Antonio Martinez-Cuesta (2), Alberto Benito (2), Javier Rodriguez (4), Angel Panizo (5), Belen Gil (1), Mercedes Inarrairaegui (1), Ignacio Herrero (1), Jorge Quiroga (1), Jesus Prieto (1).
(1) Liver Unit, Department of Internal Medicine, Clinica Universitaria de Navarra, Pamplona, Spain
(2) Department of Radiology, Clinica Universitaria de Navarra, Pamplona, Spain
(3) Department of Nuclear Medicine, Clinica Universitaria de Navarra, Pamplona, Spain
(4) Department of Medical Oncology, Clinica Universitaria de Navarra, Pamplona, Spain
(5) Department of Pathology, Clinica Universitaria de Navarra, Pamplona, Spain
To investigate the antitumor effect of resin microspheres loaded with 90-yttrium against hepatocellular carcinoma and their safety in the setting of liver cirrhosis.
PATIENTS AND METHODS
Data from 24 consecutive patients with hepatocellular carcinoma (HCC) treated by radioembolization in the period from September 2003 to February 2005 were reviewed. Patients received no further antineoplastic therapy. A comprehensive evaluation was performed to prevent the risk of damage due to microsphere misplacing. Patients were discharged the day after microspheres injection.
Serious liver toxicity observed among cirrhotic patients in a first period was subsequently prevented by modifying the selection criteria and the method for calculating the activity to be administered. Among 21 patients evaluable for response using Response Evaluation Criteria in Solid Tumors (RECIST) criteria, a reduction in size of target lesions was observed in all but 1 patient. When considering only target lesions, disease control rate and response rate were 100% and 23.8%, respectively. However, 43% of patients progressed in the liver in the form of new lesions appearing a median time of 3 months after radioembolization.
Our experience in these series of patients indicates that radioembolization using resin microspheres has a significant antitumor effect against HCC and that using stringent selection criteria and conservative models for calculating the radiation activity to be administered, radioembolization can be performed safely even in cirrhotic patients.
CITATION Int J Radiat Oncol Biol Phys. 2006 Nov 1;66(3):792-800