Radioembolization as Salvage Therapy for Hepatic Metastasis of Uveal Melanoma: A Single-Institution Experience

Gonsalves, Carin F.; Eschelman, David J.; Sullivan, Kevin L.; Anné, Pramila R.; Doyle, Laura; Sato, Takami

doi:10.2214/ajr.10.4881

Cited by 112 publications

(82 citation statements)

References 30 publications

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“…In the first study of 11 patients investigating the use of 90 Y SIR-Spheres to treat uveal melanoma, a response rate of 100% and a 1-year survival rate of 80% were reported for the 10 subjects who could be contacted for follow-up, with 1 patient experiencing a complete response at 3 months as assessed by PET/CT [21]. Since the original investigation [21], more recent studies have reported median disease progression-free and overall survivals ranging from 4.7 to 5.9 and from 7 to 12.3 months, respectively, among patients with uveal melanoma liver metastases treated with 90 Y microsphere radioembolization [22,23,24]. …”

Section: Discussionmentioning

confidence: 99%

Reduction of Nodular Growth Pattern of Metastatic Uveal Melanoma after Radioembolization of Hepatic Metastases

et al. 2015

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Aim: The aim of this study was to report a case of metastatic uveal melanoma in which radioembolized nodular liver metastases decreased in size while infiltrative sinusoidal metastases progressed, leading to jaundice without obstruction of the biliary ducts. Methods: The relevant clinical features, imaging, and histopathologic findings of this case are reviewed. Results: A 61-year-old Caucasian male with a history of uveal melanoma of the left eye status post plaque brachytherapy developed numerous liver metastases. After progression on systemic therapies, he underwent palliative radioembolization. Despite some radiographic improvement in the liver metastases, he developed hyperbilirubinemia without biliary tract obstruction or signs of liver failure. A biopsy of radiographically normal liver demonstrated extensive sinusoidal infiltration with melanoma. Conclusions: Distinct angiographic and histopathologic growth patterns of metastatic uveal melanoma differ in their amenability to radioembolization. Sinusoidal infiltration may lead to hyperbilirubinemia in the absence of overt obstruction or liver failure.

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Section: Discussionmentioning

confidence: 99%

Reduction of Nodular Growth Pattern of Metastatic Uveal Melanoma after Radioembolization of Hepatic Metastases

et al. 2015

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“…For those with chemorefractory liver metastases, liverdirected therapy is a preferred approach to reduce tumor burden and prolong overall survival. Unfortunately, only a very small subset (~9%) of patients are eligible for resection (114,115). Treatment options for unresectable hepatic metastatic melanoma have historically been poor.…”

Section: Role Of Palliative Rt For Melanomasmentioning

confidence: 99%

“…Treatment options for unresectable hepatic metastatic melanoma have historically been poor. Recent studies utilizing Yttrium-90 ( 90 Y) radioembolization have led to encouraging results (114,(116)(117)(118). This is a special form of radiation that was initially established for the treatment of hepatocellular carcinoma and liver metastasis (119)(120)(121).…”

Section: Role Of Palliative Rt For Melanomasmentioning

confidence: 99%

Radiation Therapy for Melanoma

Shi

2017

Cutaneous Melanoma: Etiology and Therapy

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Although melanoma is a relative radioresistant tumor, radiation therapy (RT) remains a valid and effective treatment option for the management of melanoma. RT as a primary treatment is often offered in well-defined situations, such as medical inoperability, lentiginous melanoma, mucosal melanoma, and ocular melanoma. Adjuvant RT following lymphadenectomy in node-positive melanoma patients prevents local and regional recurrence; however, the role of adjuvant RT remains controversial and underutilized due to lack of overall survival benefit. On the other hand, RT is highly effective in providing symptom palliation for metastatic melanoma and is widely used. Advanced RT technologies such as stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) can achieve excellent local control with minimum toxicities. They are commonly used in the management of brain, lung, spine, and liver metastases. Most recently, it is under active investigation on combining RT with new systemic options, such as targeted therapy, or immunotherapy. The advancements in the treatment of patients with melanoma highlight the importance of multidisciplinary management in this disease. Radiation therapy will continue to be one of the key therapeutic options.

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“…Increasing numbers of patients with liver only recurrent breast cancer or (ocular) melanoma are reported [1][2][3]. The tumor specific pitfalls and recommendations regarding pre-SIRT imaging are discussed here under.…”

Section: Pre-treatment Tumor Extension Assessmentmentioning

confidence: 99%

New Imaging Techniques for 90Y Microsphere Radioembolization

Vouche¹,

Vanderlinden²,

Delatte³

et al. 2011

J Nucl Med Radiat Ther

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Adequate patient selection and treatment planning is crucial for a safe and cost-effective administration of selective internal radiotherapy (SIRT) of malignant liver disease using 90 Y-labelled microspheres. It requires the implementation of multimodality imaging, integrating metabolic, functional and structural characteristics. A multidisciplinary approach is a prerequisite for SIRT, bringing together the knowhow and expertise of radiologists, nuclear medicine physicians, medical physicists, imaging engineers, and radiotherapists. This review discusses the available radiologic (CT/MRI) and nuclear (SPECT/PET) imaging modalities and their specific utility in the different diagnostic phases related to SIRT: wholebody and intrahepatic pre-treatment disease staging, CT and MRI-based angiography, liver-lung shunt assessment, treatment simulation, predictive dosimetry, post-treatment imaging, and SIRT response assessment.

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Radioembolization as Salvage Therapy for Hepatic Metastasis of Uveal Melanoma: A Single-Institution Experience

Abstract: Radioembolization is safe and effective salvage therapy for limited metastasis of uveal melanoma.

Cited by 112 publications

References 30 publications

Reduction of Nodular Growth Pattern of Metastatic Uveal Melanoma after Radioembolization of Hepatic Metastases

Reduction of Nodular Growth Pattern of Metastatic Uveal Melanoma after Radioembolization of Hepatic Metastases

Radiation Therapy for Melanoma

New Imaging Techniques for 90Y Microsphere Radioembolization

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