Abstract
Objectives
Yttrium-90 radioembolization is a hepatic intra-arterial-based therapy using glass- or resin-based microspheres as carriers to deliver high-dose radiation to tumors to maximize dose while minimizing collateral damage. This study aimed to compare the safety and efficacy of glass (TheraSphere) versus resin (Selective Internal Radiation Spheres, SIR-Spheres) Y-90 in the treatment of intrahepatic metastatic disease.
Methods
A review of a prospectively collected, institutional review board-approved database was conducted to identify patients who underwent Y-90 therapy, excluding those with hepatocellular carcinoma (HCC).
Results
Of 119 patients, 79 received SIR-Spheres and 40 received TheraSphere therapy. For intrahepatic cholangiocarcinoma, mean survival was 10.6 months in the SIR-Spheres group compared to 29.2 months in the TheraSphere group (log-rank 0.05). In colorectal cancer (CRC), mean survival was 16.3 months for SIR-Spheres therapy and 26.8 for TheraSphere therapy (log-rank 0.097). There were no documented severe (grade 3) side effects in the TheraSphere group compared to 14 % of patients who experienced side effects in the SIR-Spheres group.
Conclusions
TheraSphere microsphere appears superior to SIR-Spheres in treating non-HCC intrahepatic malignancy. However, patient selection and better multi-disciplinary care may play a role in these differences. Continued studies in combination therapies for all hepatic malignancies is critical to the long-term success and sustainability of Y-90 therapy.
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References
Breedis C, Young G (1954) The blood supply of neoplasms in the liver. Am J Pathol 30(5):969–977
Kennedy AS et al (2006) Resin 90Y-microsphere brachytherapy for unresectable colorectal liver metastases: modern USA experience. Int J Radiat Oncol Biol Phys 65(2):412–425
Lewandowski RJ, Salem R (2006) Yttrium-90 radioembolization of hepatocellular carcinoma and metastatic disease to the liver. Semin Intervent Radiol 23(1):64–72
Kulik LM et al (2006) Yttrium-90 microspheres (TheraSphere) treatment of unresectable hepatocellular carcinoma: downstaging to resection, RFA and bridge to transplantation. J Surg Oncol 94(7):572–586
Salem R, Thurston KG (2006) Radioembolization with 90Yttrium microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies. Part 1: technical and methodologic considerations. J Vasc Interv Radiol 17(8):1251–1278
Lau WY et al (2004) Salvage surgery following downstaging of unresectable hepatocellular carcinoma. Ann Surg 240(2):299–305
Kim DY et al (2006) Successful embolization of hepatocelluar carcinoma with yttrium-90 glass microspheres prior to liver transplantation. J Gastrointest Surg 10(3):413–416
Al-Adra DP et al (2015) Treatment of unresectable intrahepatic cholangiocarcinoma with yttrium-90 radioembolization: a systematic review and pooled analysis. Eur J Surg Oncol 41(1):120–127
Coldwell D, K.A. Treatment of nodular cholangiocarcinoma with yttrium-90 microspheres. In World Congress on Gastrointestinal Cancer 2006. Barcelona, Spain.
Zhang Z et al (2013) Comparison of therapeutic response using RECIST criteria: Y-90 SIR-Spheres and TheraSphere treatment of unresectable hepatocellular carcinoma. J NUCL MED MEETING ABSTRACTS 54(2_MeetingAbstracts):224
Zhang Z et al (2012) Comparison study of the treatment of unresectable hepatocellular carcinoma with Y-90 SIR-Spheres and Y-90 TheraSphere. J Nucl Med 53(supplement 1):1201
Woodall CE et al (2009) Is selective internal radioembolization safe and effective for patients with inoperable hepatocellular carcinoma and venous thrombosis? J Am Coll Surg 208(3):375–382
Kennedy AS et al (2006) Resin 90Y-microsphere brachytherapy for unresectable colorectal liver metastases: modern USA experience. IntJRadiatOncolBiolPhys 65(2):412–425
Choi H et al (2007) Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria. J Clin Oncol 25(13):1753–1759
Llovet JM et al (2008) Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst 100(10):698–711
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The work was supported by the Division of Surgical Oncology at the University of Louisville School of Medicine.
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The authors declare that they have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Burnett, N.P., Akinwande, O., Scoggins, C.R. et al. Comparison of Yttrium-90 therapy for unresectable liver metastasis: glass versus biocompatible resin microspheres. J Radiat Oncol 6, 101–108 (2017). https://doi.org/10.1007/s13566-016-0282-3
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DOI: https://doi.org/10.1007/s13566-016-0282-3