Yttrium-90 Microspheres: A Review of Its Emerging Clinical Indications

Abstract

Background: Many patients with liver malignancies are not candidates for resection, and systemic therapies are often not effective. Radioembolization (RE) is an alternative treatment for this group of patients. The safety and efficacy of RE with yttrium 90 (Y90) in patients with hepatocellular carcinoma (HCC) or metastatic colon cancer to the liver have been proven in several studies. However, fewer studies have focussed on the safety and efficacy of RE with Y90 in other extrahepatic primary and secondary liver cancers. The effect on outcomes of concomitant use of Y90 with a systemic therapy is still currently under investigation. Summary: A review of the published data on the use of RE as stand-alone, concomitant or sequential with other treatment modalities in HCC and other primary and secondary liver cancer is reported here. Key message: RE for the treatment of HCC and other extrahepatic, primary and secondary liver cancer has reasonable efficacy and acceptable toxicities. Definitive studies to establish the role of RE in the treatment of such malignancies are warranted.

General Rules for the Clinical and Pathological Study of Primary Liver Cancer, Nationwide Follow-Up Survey and Clinical Practice Guidelines: The Outstanding Achievements of the Liver Cancer Study Group of Japan

“…This huge database is an extremely important asset that is not available in any other country. Because HCC was treated only by surgical resection [15,16,17] in the 1970s before locoregional therapy [18,19,20,21,22] was developed in the 1980s, the general rules describe surgery-related items and the macroscopic and histopathological findings of surgical specimens in immense detail. In contrast, descriptions of locoregional therapies, such as ablation [21] and transcatheter arterial chemoembolization (TACE) [13,23,24], were relatively scarce up until the fourth edition, which was published in 2001.…”

Challenges of Clinical Research on Hepatocellular Carcinoma

“…Outside Japan, transarterial radioembolization is being frequently performed [80,81]. Its introduction to Japan is eagerly awaited.…”

Application of Ion-Exchange Resin Column for Basic Development of Strontium-90/Yttrium-90 Generator for Preparation of Radiopharmaceutical Therapy

“…It is in line with the speed of antibody accumulation in tumor cells [6][7]. In a tumor cell, the energy of 2.26 MeV will produce an attacking effect by delivering radiation to a tumor cell; a cell adjacent to tumor cell-a tumor cell that hides its self as antigens as well as bulky tumor [8].…”