Radiation segmentectomy of hepatic metastases with Y-90 glass microspheres

Kurilova, Ieva; Bendet, Achiude; Fung, Edward K.; Petre, Elena N.; Humm, John L.; Boas, F.; Crane, Christopher H.; Kemeny, Nancy E.; Kingham, T. Peter; Cercek, Andrea; D’Angelica, Michael I.; Sofocleous, Constantinos T.

doi:10.1007/s00261-021-02956-6

Cited by 19 publications

(12 citation statements)

References 40 publications

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“…With a mean tumor dose of 261 Gy, five out of ten patients showed a complete metabolic response according to PET response criteria in solid tumors (PERCIST), with a mean PFS of 7.1 months. In a separate study by Kurilova et al [128], 10 patients with 14 CRLM underwent RS, demonstrating a response rate of 100% and 44% according to the per Choi and RECIST 1.1 criteria, respectively. With a median deliver dose of 293 Gy, reported median OS in this small cohort was 41.5 months, with a 2-year local tumor control rate of 83%.…”

Section: Y-90 Sirt In the Neoadjuvant Setting (Radiation Lobectomy And Radiation Segmentectomy)mentioning

confidence: 97%

Review of Intra-Arterial Therapies for Colorectal Cancer Liver Metastasis

Kwan

Pua

2021

Cancers

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The liver is frequently the most common site of metastasis in patients with colorectal cancer, occurring in more than 50% of patients. While surgical resection remains the only potential curative option, it is only eligible in 15–20% of patients at presentation. In the past two decades, major advances in modern chemotherapy and personalized biological agents have improved overall survival in patients with unresectable liver metastasis. For patients with dominant liver metastatic disease or limited extrahepatic disease, liver-directed intra-arterial therapies such as hepatic arterial chemotherapy infusion, chemoembolization and radioembolization are treatment strategies which are increasingly being considered to improve local tumor response and to reduce systemic side effects. Currently, these therapies are mostly used in the salvage setting in patients with chemo-refractory disease. However, their use in the first-line setting in conjunction with systemic chemotherapy as well as to a lesser degree, in a neoadjuvant setting, for downstaging to resection have also been investigated. Furthermore, some clinicians have considered these therapies as a temporizing tool for local disease control in patients undergoing a chemotherapy ‘holiday’ or acting as a bridge in patients between different lines of systemic treatment. This review aims to provide an update on the current evidence regarding liver-directed intra-arterial treatment strategies and to discuss potential trends for the future.

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Section: Y-90 Sirt In the Neoadjuvant Setting (Radiation Lobectomy And Radiation Segmentectomy)mentioning

confidence: 97%

Review of Intra-Arterial Therapies for Colorectal Cancer Liver Metastasis

Kwan

Pua

2021

Cancers

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“…Numerous studies have demonstrated the safety of this approach and increasingly higher rates of complete pathologic necrosis with higher doses in various tumor types. [116][117][118] Whereas the vast literature is on HCC, outcomes of this strategy for cholangiocarcinoma will be forthcoming.…”

Section: Transarterial Embolotherapies For Unresectable Liverconfined...mentioning

confidence: 99%

Advances in the treatment of intrahepatic cholangiocarcinoma: An overview of the current and future therapeutic landscape for clinicians

Moris

Palta

Kim

et al. 2022

CA A Cancer J Clinicians

160

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Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver tumor and remains a fatal malignancy in the majority of patients. Approximately 20%-30% of patients are eligible for resection, which is considered the only potentially curative treatment; and, after resection, a median survival of 53 months has been reported when sequenced with adjuvant capecitabine. For the 70%-80% of patients who present with locally unresectable or distant metastatic disease, systemic therapy may delay progression, but survival remains limited to approximately 1 year. For the past decade, doublet chemotherapy with gemcitabine and cisplatin has been considered the most effective first-line regimen, but results from the recent use of triplet regimens and even immunotherapy may shift the paradigm.More effective treatment strategies, including those that combine systemic therapy with locoregional therapies like radioembolization or hepatic artery infusion, have also been developed. Molecular therapies, including those that target fibroblast growth factor receptor and isocitrate dehydrogenase, have recently received US Food and Drug Administration approval for a defined role as second-line treatment for up to 40% of patients harboring these actionable genomic alterations, and whether they should be considered in the first-line setting is under investigation. Furthermore, as the oncology field seeks to expand indications for immunotherapy, recent data demonstrated that combining durvalumab with standard cytotoxic therapy improved survival in patients with ICC. This review focuses on the current and future strategies for ICC treatment, including a summary of the primary literature for each treatment modality and an algorithm that can be used to drive a personalized and multidisciplinary approach for patients with this challenging malignancy.

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“…Kurilova et al treated 10 patients with ≤ 3 LM and limited treatment options. Y90 radiation segmentectomy can provide a 2-year local tumor control rate of 83% [ 235 ].…”

Section: Emerging Technologies and Future Directionsmentioning

confidence: 99%

Local Treatments in the Unresectable Patient with Colorectal Cancer Metastasis: A Review from the Point of View of the Medical Oncologist

Torres-Jiménez

Esteban-Villarrubia

Ferreiro-Monteagudo

et al. 2021

Cancers

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For patients with isolated liver metastases from colorectal cancer who are not candidates for potentially curative resections, non-surgical local treatments may be useful. Non-surgical local treatments are classified according to how the treatment is administered. Local treatments are applied directly on hepatic parenchyma, such as radiofrequency, microwave hyperthermia and cryotherapy. Locoregional therapies are delivered through the hepatic artery, such as chemoinfusion, chemoembolization or selective internal radiation with Yttrium 90 radioembolization. The purpose of this review is to describe the different interventional therapies that are available for these patients in routine clinical practice, the most important clinical trials that have tried to demonstrate the effectiveness of each therapy and recommendations from principal medical oncologic societies.

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Radiation segmentectomy of hepatic metastases with Y-90 glass microspheres

Cited by 19 publications

References 40 publications

Review of Intra-Arterial Therapies for Colorectal Cancer Liver Metastasis

Review of Intra-Arterial Therapies for Colorectal Cancer Liver Metastasis

Advances in the treatment of intrahepatic cholangiocarcinoma: An overview of the current and future therapeutic landscape for clinicians

Local Treatments in the Unresectable Patient with Colorectal Cancer Metastasis: A Review from the Point of View of the Medical Oncologist

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