Yttrium-90 Radioembolization as Salvage Therapy for Liver Metastases From Colorectal Cancer

Abstract

Y-90 radioembolization as a salvage therapy for chemotherapy-resistant hepatic metastases from colon cancer was safe and resulted in disease stability. Response on PET was an independent predictor of superior overall survival.

Interventional Treatment of Hepatic Metastases from Colorectal Cancer

“…42 With respect to disease burden, the absence of extrahepatic disease and tumor burden 25% are associated with improved survival. 40,[42][43][44] A 30% response of CEA at 3 months posttreatment 43 and response on PET 48 were both associated with improved OS, while an elevated pretreatment CEA 40 was associated with worse OS. Two or fewer chemotherapeutic agents are also associated with better survival outcomes.…”

Yttrium-90 Hepatic Radioembolization for Advanced Chemorefractory Metastatic Colorectal Cancer: Survival Outcomes Based on Right- Versus Left-Sided Primary Tumor Location

“…After possible dose adjustment based on the shunt study, Y90 microspheres were infused into the target hepatic artery. Treatment approach, as determined by interventional radiologist preference and/or liver tumor distribution, included unilobar therapy, single session whole liver therapy, and sequential bilobar therapies on different dates [19]. Unilobar treatment was performed when tumors were confined to one hepatic lobe.…”

“…Liver-directed radioembolization with yttrium-90 (Y90) microspheres is also recommended in patients with chemorefractory mCRC and liver-dominant or liver-only disease according to current National Comprehensive Cancer Network guidelines [12]. Y90 radioembolization is a safe and effective treatment for patients with chemorefractory liver metastases [13][14][15] and achieves improvements in survival, disease progression, and tumor response rates in these patients [16][17][18][19]. In current clinical practice, Y90 is commonly used as a salvage therapy for progressive mCRC liver metastases in chemorefractory patients following failure of second-or third-line chemotherapy regimens [20][21][22].…”

Radioembolization in Colorectal Metastases: A Review

“…67 Over the last two decades, many studies investigated the outcomes of radioembolization therapy for hepatic metastatic colorectal cancer. 27,38,[68][69][70][71][72][73] Various iterations of radioactive microspheres have been utilized in the decades predating the currently available microspheres. [74][75][76][77][78] These early experiences were essential in determining the safe operating parameters, optimal microsphere characteristics and radioactive moiety, ultimately culminating in the current version of 90 Y radioembolic products.…”