Treatment of asymptomatic metastatic cancer to the liver from primary colon and rectal cancer by the intraarterial administration of chemotherapy and radioactive isotopes

Abstract

Forty patients with asymptomatic metastatic cancer to the liver discovered at the time of laparotomy were treated by combined intrahepatic arterial chemotherapy and internal irradiation in the form of 90Yttrium microspheres. One group of 25 patients were treated by a catheter inserted at the time of operation and received 100 mCi; of 90Yttrium microspheres and 5-fluorouracil on a continuing basis. They survived an average of 26 mo (varying from 9 to 60 mo). The second series of 15 patients referred after surgery were treated by the percutaneous insertion of the catheter into the hepatic artery and received a bolus of combined chemotherapy consisting of PlatinolTM, Methotrexate, and 5-fluorouracil. They survived an average of 31 mo, which varied from 12 to 60 mo. The dose of 100 mCi of 90Yttrium was well tolerated by the liver. Prospective studies are in progress, limiting the treatment to the internal irradiation to determine its precise role in the overall treatment of metastatic cancer to the liver.

Yttrium-90 hepatic radioembolization: clinical review and current techniques in interventional radiology and personalized dosimetry

“…Subsequent clinical trials involved several successful treatments of metastatic CRC to the liver. 4,5 This therapeutic modality has since been incorporated into early nuclear medicine literature following its initial clinical applications. 6-8 90 Y microsphere radioembolization is presently used for local control of both primary as well as metastatic liver tumours which are unresectable.…”

Safety and efficacy of Y-90 microsphere treatment in patients with primary and metastatic liver cancer: The tumor selectivity of the treatment as a function of tumor to liver flow ratio

“…The technique was introduced by Ariel [7], who also reported the first series of successful treatment in patients with metastatic colorectal cancer (CRC) [8,9]. Ariel's patients were treated with intra-arterial chemotherapy and 100 to 150 mCi (3.7 to 5.5 GBq) of Y-90 resin microspheres.…”

90Y Microspheres: Concepts and Principles

“…The infusion of 15-30 million spheres showed 6-10 times as many microspheres in the periphery of the tumors compared with the normal liver (p\0.008) (Pillai et al 1991). (Ariel 1965;Ariel and Pack 1967;Ariel and Padula 1982;Blanchard et al 1964Blanchard et al , 1965Grady 1979) with significant interest in this approach developing in the US since 2000 (Kennedy et al 2001a(Kennedy et al , b, 2002aKennedy and Salem 2003;Murthy et al 2002a, b, c;Van Echo et al 2001;Coldwell et al 2001;Salem et al 2002;Sarfaraz et al 2001;Carr et al 2002a, b). The study of microspheres in the livers of humans after treatment for both metastatic colon and primary hepatoma have been published from a review of biopsy (Fox et al 1991) of the left lobe (Campbell et al 2000) and four entire livers (Kennedy et al 2004).…”