Results in Liver Metastatic Colorectal Cancer

  • Javier Rodríguez
  • Ana Chopitea
  • Bruno Sangro
  • José Ignacio Bilbao
Part of the Medical Radiology book series (MEDRAD)


Radioembolization (RE) is an increasingly used form of brachytherapy which consists of intraarterially injected microspheres loaded with 90Y (a pure beta emitter with a 2.6-day half-life and an average 2.5-mm tissue penetration) as a source for internal radiation purposes. Its aim is to deliver tumoricidal doses of radiation to no matter how many liver tumors at a time while sparing the nontumoral liver from absorbing harmful doses of radiation. Colorectal cancer is one of the leading causes of cancer death worldwide, with the liver being the most common site of metastatic disease. Standard treatment for these patients with unresectable disease involves systemic therapy with either chemotherapy or targeted agents. In recent years, selective internal radiation therapy with embolization of branches of the hepatic artery with biocompatible resin-based 90Y-labeled microspheres has emerged as a valuable tool for patients with this disease. Several phase I/II and randomized trials have proved the ability of SIR-Spheres to produce significant rates of tumor growth control among patients with liver metastases from colorectal cancer. Although the most promising data emerge from combinatorial approaches with systemic therapy, data supporting the use of 90Y-RE as a stand-alone modality, especially in the salvage setting, are provided. Available clinical data with this therapeutic modality are discussed and compared to currently approved standard of care. In addition, this chapter highlights preliminary data regarding the discovery of potential predictive biomarkers of efficacy and efforts made in the field toward a personalized medicine.


Epidermal Growth Factor Receptor Best Supportive Care Total Lesion Glycolysis Extrahepatic Disease Hepatic Arterial Infusion Chemotherapy 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Javier Rodríguez
    • 1
  • Ana Chopitea
    • 1
  • Bruno Sangro
    • 2
  • José Ignacio Bilbao
    • 3
  1. 1.Unit for the Research and Treatment of Gastrointestinal Malignancies, Department of Medical OncologyClinica Universidad de Navarra, University of NavarraPamplonaSpain
  2. 2.Liver UnitClínica Universidad de Navarra, University of NavarraPamplonaSpain
  3. 3.Unit of Interventional RadiologyClínica Universidad de Navarra, University of NavarraPamplonaSpain

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