Abstract
Objective To evaluate the outcomes of patients receiving Y- 90 SIR-Spheres in patients with multiple liver metastases from different tumors. Methods: 29 consecutive patients with multiple liver metastases from colorectal (13), Islet cell tumors (9), carcinoid tumors (4) or non-small cell lung cancer (3) who were treated with Y-90 SIR-Spheres between March, 2003 and February, 2006 were included. Only patients who had follow-up radiological exams at our institution were included. Data regarding Y-90 SIR-Spheres dose, lobe of liver treated, and chemotherapy (CTx) administered were collected. Patients’ outcomes were evaluated based on radiological evidence of change in size and number of liver metastases. Results: The study population included 8 females and 21 males at a mean age of 60y. The mean Y-90 SIR-Spheres dose administered was 39.8 mCi. Both lobes of the liver, the right lobe only or the left lobe only were treated in 26, 2, 1 patients, respectively. Sixteen patients received Y-90 SIR-Spheres after CTx failure, 5 patients as adjuvant therapy after completion of CTx, 7 patients as concurrent therapy and one patient refused repeat CTx. The mean interval between the last CTx and Y-90 SIR-Spheres was 108 days. Four patients (14%) demonstrated radiological improvement and 9 (31%) were stable for a mean interval of 2.8 mo. after Y-90 SIR-Spheres infusion. Sixteen patients (55%) demonstrated continued progress of liver metastases. Conclusion: Y-90 SIR-Spheres therapy is useful in reducing or stabilizing multiple liver metastases from a variety of tumors.
Highlights
The eradication of multiple liver metastases from different tumors is a difficult goal to achieve in most tumors
More selective internal radiation therapy to liver metastases using Y90 labeled microspheres is an acceptable alternative with multiple studies demonstrating its effects in treating metastases from colorectal cancer (Lim et al, 2005; Kennedy et al, 2006; Gray et al, 2001) and hepatocellular cancer (Lau et al, 1998; Ho et al, 1998; Sangro et al, 2006)
Liver metastases receive a higher portion of the SIR-Spheres compared to normal liver due to higher vascularity of the tumor or around it with predominant blood supply from the hepatic artery through which SIR-Spheres are injected
Summary
29 consecutive patients with multiple liver metastases from colorectal (13), Islet cell tumors (9), carcinoid tumors (4) or non-small cell lung cancer (3) who were treated with Y-90 SIR-Spheres between March, 2003 and February, 2006 were included. Patients who had follow-up radiological exams at our institution were included. Data regarding Y-90 SIR-Spheres dose, lobe of liver treated, and chemotherapy (CTx) administered were collected. Patients’ outcomes were evaluated based on radiological evidence of change in size and number of liver metastases
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