Fractionation, dose selection, and response of hepatic metastases of neuroendocrine tumors after 90Y-microsphere brachytherapy

Kennedy, Andrew S.; Dezarn, William A.; McNeillie, Patrick; Overton, Carroll; England, Mary; Sailer, Scott L.

doi:10.1016/j.brachy.2006.03.084

Cited by 9 publications

(9 citation statements)

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“…The use of 90 Y-microspheres is a safe and effective treatment for primary or metastatic solid tumors primary in the liver available worldwide, however, most treatments are for metastatic colorectal cancer or hepatocellular tumors. 19,[21][22][23][24][65][66][67][68][69][70][71][72][73] This is the first report dedicated to NETs treated with 90 Y-microspheres since Simon and Warner detailed the first 5 patients (7 treatments total) treated with this approach in 1968. 39 Since that time the microparticles have changed in composition somewhat but the sphere size and isotope and total activity delivered are the same as is performed today.…”

Section: Discussionmentioning

confidence: 88%

Radioembolization for Unresectable Neuroendocrine Hepatic Metastases Using Resin 90Y-Microspheres: Early Results in 148 Patients

Kennedy¹,

Dezarn²,

McNeillie³

et al. 2008

American Journal of Clinical Oncology

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373

214

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Radioembolization with 90Y-microspheres to the whole liver, or lobe with single or multiple fractions are safe and produce high response rates, even with extensive tumor replacement of normal liver and/or heavy pretreatment. The acute and delayed toxicity was very low without a treatment related grade 4 acute event or radiation induced liver disease in this modest-sized cohort. The significant objective response suggests that further investigation of this approach is warranted.

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Section: Discussionmentioning

confidence: 88%

Radioembolization for Unresectable Neuroendocrine Hepatic Metastases Using Resin 90Y-Microspheres: Early Results in 148 Patients

Kennedy¹,

Dezarn²,

McNeillie³

et al. 2008

American Journal of Clinical Oncology

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373

214

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Section: The Risk/benefits Of Retreatmentmentioning

confidence: 99%

“…21,22,25,26 Between 17% and 22% of patients in these studies were retreated; most received 2 treatments but a few patients received a third treatment. 20,21,25,26 In no case was retreatment of either the whole liver or fractionated treatment of the same lobe associated with RILD. 20,21,25,26 In many cases, retreatment of patients with progressive liver disease was associated with an increased duration of hepatic tumor response.…”

Section: The Risk/benefits Of Retreatmentmentioning

confidence: 99%

“…20,21,25,26 In no case was retreatment of either the whole liver or fractionated treatment of the same lobe associated with RILD. 20,21,25,26 In many cases, retreatment of patients with progressive liver disease was associated with an increased duration of hepatic tumor response. 20,21,25,26 …”

Section: The Risk/benefits Of Retreatmentmentioning

confidence: 99%

“…[20][21][22][23][24][25][26][27] Initial clinical studies and retrospective studies on a large cohort of patients indicate that radioembolization is well tolerated and highly effective in achieving a durable hepatic tumor response and ameliorating symptoms. The outcomes with various treatment modalities for mNET in the liver, relative to radioembolization, are outlined in Figure 1.…”

Section: Radioembolization In Mnetmentioning

confidence: 99%

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Integrating Radioembolization into the Treatment Paradigm for Metastatic Neuroendocrine Tumors in the Liver

Kennedy

Coldwell²,

Sangro

et al. 2012

American Journal of Clinical Oncology

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Surgical resection of hepatic metastases from neuroendocrine tumors (mNETs) is controversial because the potential survival benefit of this intervention must be balanced against the risk of surgical morbidity and mortality. In patients with unresectable mNETs in the liver, radioembolization has been used to treat tumors from a range of primary sites, including carcinoid and islet cell carcinomas as well as nonfunctional, asymptomatic tumors. Initial clinical studies and retrospective studies on a large cohort of patients indicate that radioembolization is well tolerated and highly effective in achieving a durable hepatic tumor response and ameliorating symptoms. Radioembolization using Yttrium-90 ((90)Y)-labeled resin or glass microspheres offers effective disease control and possible improved quality of life and thus merits consideration as an option for both functional and nonfunctional mNETs. Benefits of this intervention seem to extend from use in early lines of treatment to salvage of refractory disease. Radioembolization also offers a potential somatostatin analog-sparing effect in symptomatic disease.

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Radionuclide Therapy of Tumors of the Liver and Biliary Tract

Boni¹,

Guidoccio²,

Volterrani³

et al. 2016

Nuclear Oncology

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The liver represents a frequent site for both primary cancer and metastatic disease, In these circumstances, liver-directed therapies as cytoreduction via surgery or in situ ablative techniques may influence the natural history of the disease progression and improve clinical outcomes. Radioembolization (RE) is a selective internal radiotherapy technique in which 131 I-lipiodol or 90Y microspheres are infused through the hepatic arteries. It is based on the fact that primary and secondary hepatic tumors are vascularized mostly by arterial blood flow whereas the normal liver perfusion is mostly from the portal network. This enables high radiation doses to be delivered, sparing the surrounding non-malignant liver parenchyma. Although there are some clinical evidences that RE may play an important role in the management of hepatocellular carcinoma of intermediate or advanced stage and in liverdominant metastatic colorectal cancer and metastatic neuroendocrine tumors, further randomised clinical trials are mandatory to better assess the potential beneficial and harmful outcomes of trans-arterial radioembolisation either as a monotherapy or in combination with other systemic or locoregional therapies. In this chapter we discuss some technical aspects, patient selection, current clinical evidence, and future directions of radioembolisation for primary and secondary liver cancer.

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Fractionation, dose selection, and response of hepatic metastases of neuroendocrine tumors after 90Y-microsphere brachytherapy

Cited by 9 publications

References 0 publications

Radioembolization for Unresectable Neuroendocrine Hepatic Metastases Using Resin 90Y-Microspheres: Early Results in 148 Patients

Radioembolization for Unresectable Neuroendocrine Hepatic Metastases Using Resin 90Y-Microspheres: Early Results in 148 Patients

Integrating Radioembolization into the Treatment Paradigm for Metastatic Neuroendocrine Tumors in the Liver

Radionuclide Therapy of Tumors of the Liver and Biliary Tract

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