Current Colorectal Cancer Reports

, Volume 5, Issue 2, pp 93–98 | Cite as

Internal radioembolization for colorectal carcinoma liver metastases

  • Saad M. Ibrahim
  • Ahsun Riaz
  • Robert J. Lewandowski
  • Mary F. Mulcahy
  • Al B. BensonIII
  • Riad Salem
Article
First Online:
  • 39 Downloads

Abstract

Colorectal cancer remains a significant cause of morbidity and mortality. Treatment options and therapeutic interventions for patients who have disease progression despite treatment with systemic therapies have not been clearly established. However, yttrium-90 radioembolization may be useful as a minimally invasive liver-directed therapy. Although there are no large randomized controlled studies that specifically establish the role of radioembolization in this patient population, numerous studies have shown favorable toxicity and efficacy profiles and promising overall survival.

Keywords

Liver Metastasis Colorectal Liver Metastasis Radiation Pneumonitis Proper Hepatic Artery Left Hepatic Artery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Jemal A, Siegel R, Ward E, et al.: Cancer statistics, 2008. CA Cancer J Clin 2008, 58:71–96.PubMedCrossRefGoogle Scholar
  2. 2.
    Sasson AR, Sigurdson ER: Surgical treatment of liver metastases. Semin Oncol 2002, 29:107–118.PubMedCrossRefGoogle Scholar
  3. 3.
    Salem R, Thurston KG: 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 2006, 17:1251–1278. [Published erratum appears in J Vasc Interv Radiol 2006, 17:1594.PubMedGoogle Scholar
  4. 4.
    Lewandowski RJ, Sato KT, Atassi B, et al.: Radioembolization with 90Y microspheres: angiographic and technical considerations. Cardiovasc Intervent Radiol 2007, 30:571–592.PubMedCrossRefGoogle Scholar
  5. 5.
    Liu DM, Salem R, Bui JT, et al.: Angiographic considerations in patients undergoing liver-directed therapy. J Vasc Interv Radiol 2005, 16:911–935.PubMedGoogle Scholar
  6. 6.
    Salem R: Radioembolization with 90Y microspheres: technical considerations. J Vasc Interv Radiol 2007, 18:1460–1461.PubMedCrossRefGoogle Scholar
  7. 7.
    Yu AS, Keeffe EB: Management of hepatocellular carcinoma. Rev Gastroenterol Disord 2003, 3:8–24.PubMedGoogle Scholar
  8. 8.
    Salem R, Thurston KG, Carr BI, et al.: Yttrium-90 microspheres: radiation therapy for unresectable liver cancer. J Vasc Interv Radiol 2002, 13(9 Pt 2):S223–S229.PubMedCrossRefGoogle Scholar
  9. 9.
    Rhee TK, Omary RA, Gates V, et al.: The effect of catheter-directed CT angiography on yttrium-90 radioembolization treatment of hepatocellular carcinoma. J Vasc Interv Radiol 2005, 16:1085–1091.PubMedGoogle Scholar
  10. 10.
    Lewandowski RJ, Sato KT, Atassi B, et al.: Radioembolization with 90Y microspheres: angiographic and technical considerations. Cardiovasc Intervent Radiol 2007, 30:571–592.PubMedCrossRefGoogle Scholar
  11. 11.
    Kim HC, Chung JW, Lee W, et al.: Recognizing extrahepatic collateral vessels that supply hepatocellular carcinoma to avoid complications of transcatheter arterial chemoembolization. Radiographics 2005, 25(Suppl 1):S25–S39.PubMedCrossRefGoogle Scholar
  12. 12.
    Murthy R, Nunez R, Szklaruk J, et al.: Yttrium-90 microsphere therapy for hepatic malignancy: devices, indications, technical considerations, and potential complications. Radiographics 2005, 25(Suppl 1):S41–S55.PubMedCrossRefGoogle Scholar
  13. 13.
    Sato KT, Omary RA, Ryu R, et al.: Radioembolization with yttrium-90 microspheres: angiographic and technical considerations. Tech Vasc Interv Radiol 2007, 10:12–29.PubMedCrossRefGoogle Scholar
  14. 14.
    Ho S, Lau WY, Leung TW, et al.: Partition model for estimating radiation doses from yttrium-90 microspheres in treating hepatic tumours. Eur J Nucl Med 1996, 23:947–952.PubMedCrossRefGoogle Scholar
  15. 15.
    Ho S, Lau WY, Leung TW, et al.: Clinical evaluation of the partition model for estimating radiation doses from yttrium-90 microspheres in the treatment of hepatic cancer. Eur J Nucl Med 1997, 24:293–298.PubMedGoogle Scholar
  16. 16.
    Salem R, Parikh P, Atassi B, et al.: Incidence of radiation pneumonitis after hepatic intra-arterial radiotherapy with yttrium-90 microspheres assuming uniform lung distribution. Am J Clin Oncol 2008, 31:431–438.PubMedCrossRefGoogle Scholar
  17. 17.
    Salem R, Lewandowski RJ, Sato KT, et al.: Technical aspects of radioembolization with 90Y microspheres. Tech Vasc Interv Radiol 2007, 10:12–29.PubMedCrossRefGoogle Scholar
  18. 18.
    Salem R, Thurston KG: Radioembolization with 90yttrium microspheres: a state-of-the-art brachytherapy treatment for primary and secondary liver malignancies. Part 2: special topics. J Vasc Interv Radiol 2006, 17:1425–1439.PubMedCrossRefGoogle Scholar
  19. 19.
    Gray B, Van Hazel G, Hope M, et al.: Randomised trial of SIR-Spheres plus chemotherapy vs. chemotherapy alone for treating patients with liver metastases from primary large bowel cancer. Ann Oncol 2001, 12:1711–1720.PubMedCrossRefGoogle Scholar
  20. 20.
    Stubbs RS, Cannan RJ, Mitchell AW: Selective internal radiation therapy with 90yttrium microspheres for extensive colorectal liver metastases. J Gastrointest Surg 2001, 5:294–302.PubMedCrossRefGoogle Scholar
  21. 21.
    Stubbs RS, Cannan RJ, Mitchell AW: Selective internal radiation therapy (SIRT) with 90Yttrium microspheres for extensive colorectal liver metastases. Hepatogastroenterology 2001, 48:333–337.PubMedGoogle Scholar
  22. 22.
    Van Hazel G, Blackwell A, Anderson J, et al.: Randomised phase 2 trial of SIR-Spheres plus fluorouracil/leucovorin chemotherapy versus fluorouracil/leucovorin chemotherapy alone in advanced colorectal cancer. J Surg Oncol 2004, 88:78–85.PubMedCrossRefGoogle Scholar
  23. 23.
    Van Hazel G, Price D, Bower G, et al.: Selective internal radiation therapy (SIRT) for liver metastases with concomitant systemic oxaliplatin, 5-fluorouracil and folinic acid: a phase I/II dose escalation study. ASCO Annual Meeting Proceedings; 2005. Abstract 3657.Google Scholar
  24. 24.
    Goldstein D, Van Hazel G, Pavlakis N, Olver I: Selective Internal Radiation therapy (SIRT) plus systemic chemotherapy with Irinotecan: A phase I dose escalation study. ASCO Annual Meeting Proceedings; 2005. Abstract 3701.Google Scholar
  25. 25.
    Sharma RA, Van Hazel GA, Morgan B, et al.: Radioembolization of liver metastases from colorectal cancer using yttrium-90 microspheres with concomitant systemic oxaliplatin, fluorouracil, and leucovorin chemotherapy. J Clin Oncol 2007, 25:1099–1106.PubMedCrossRefGoogle Scholar
  26. 26.
    Kennedy AS, Coldwell D, Nutting C, et al.: Resin 90Ymicrosphere brachytherapy for unresectable colorectal liver metastases: modern USA experience. Int J Radiat Oncol Biol Phys 2006, 65:412–425.PubMedGoogle Scholar
  27. 27.
    Mulcahy MF, Lewandowski RJ, Ibrahim SM, et al.: Radioembolization of colorectal hepatic metastases using yttrium-90 microspheres. Cancer 2009 (in press).Google Scholar
  28. 28.
    Jakobs TF, Hoffmann RT, Dehm K, et al.: Hepatic yttrium-90 radioembolization of chemotherapy-refractory colorectal cancer liver metastases. J Vasc Interv Radiol 2008, 19:1187–1195.PubMedCrossRefGoogle Scholar
  29. 29.
    Sato KT, Lewandowski RJ, Mulcahy MF, et al.: Unresectable chemorefractory liver metastases: radioembolization with 90Y microspheres—safety, efficacy, and survival. Radiology 2008, 247:507–515.PubMedCrossRefGoogle Scholar
  30. 30.
    Messersmith W, Laheru D, Hidalgo M: Recent advances in the pharmacological treatment of colorectal cancer. Expert Opin Investig Drugs 2003, 12:423–434.PubMedCrossRefGoogle Scholar
  31. 31.
    Hoff PM: Future directions in the use of antiangiogenic agents in patients with colorectal cancer. Semin Oncol 2004, 31:17–21.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group, LLC 2009

Authors and Affiliations

  • Saad M. Ibrahim
  • Ahsun Riaz
  • Robert J. Lewandowski
  • Mary F. Mulcahy
  • Al B. BensonIII
  • Riad Salem
    • 1
  1. 1.Department of Radiology, Robert H. Lurie Comprehensive Cancer CenterNorthwestern UniversityChicagoUSA

Personalised recommendations