Radioembolization-Induced Chronic Hepatotoxicity: A Single-Center Cohort Analysis

Currie, B.; Hoteit, Maarouf; Ben‐Josef, Edgar; Nadolski, Gregory J.; Soulen, Michael C.

doi:10.1016/j.jvir.2019.06.003

Cited by 49 publications

(41 citation statements)

References 27 publications

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“…44 Currie et al found delayed hepatotoxicity in 13% of NET patients treated with TARE, including five deaths attributed to thera-py. 47 The authors noted a trend toward significance in total dose administered. Therefore, concerns regarding long-term liver toxicity related to TARE must be understood in the context of pattern of liver involvement (see later) and planned treatment.…”

Section: Ldt Modalitymentioning

confidence: 97%

Liver-Directed Therapy for Gastroenteropancreatic NETs in the Era of Peptide Receptor Radionuclide Therapy

González-Aguirre

Ziv

2020

Digestive Disease Interventions

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Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) represent a heterogeneous group of tumors. Current treatment algorithms for these tumors are complex and often require a multidisciplinary approach. Recently, peptide receptor radionuclide therapy (PRRT) was granted Food and Drug Administration approval, making this treatment widely available in the United States. PRRT is now another therapeutic option for patients with GEP-NETs. To date there are no consensus guidelines about how to sequence multiple treatment options. Moreover, there is concern of potential liver toxicity when PRRT is used before or after liver-directed therapies (LDTs). In this review, we describe the characteristics of the most commonly used LDT and their potential interactions with PRRT, as well as specific clinical scenarios that are relevant when deciding on the use of LDT. We also review the limited case series that have been published involving patients treated with different combinations of LDT and PRRT. Finally, we discuss some of the future directions for GEP-NET treatments.

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Section: Ldt Modalitymentioning

confidence: 97%

Liver-Directed Therapy for Gastroenteropancreatic NETs in the Era of Peptide Receptor Radionuclide Therapy

González-Aguirre

Ziv

2020

Digestive Disease Interventions

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“…Liver toxicity is a constant adverse event but mostly asymptomatic [ 101 ]. Radioembolization-induced liver disease (REILD) may occur after 0% to 13% of SIRTs [ 101 , 102 ]. It is a potentially life-threatening complication with liver damages characterized by jaundice and ascites, which appear between 4 and 8 weeks after SIRT [ 103 ].…”

Section: Selective Internal Radiation Therapy (Sirt)mentioning

confidence: 99%

“…It is a potentially life-threatening complication with liver damages characterized by jaundice and ascites, which appear between 4 and 8 weeks after SIRT [ 103 ]. Mortality of REILD may reach up to 30% [ 102 ]. A radiation dose-to-liver volume ratio >0.8 GBq/L, an elevated dose to normal liver (>50 Gy), pre-existing liver disease, previous chemotherapy, whole liver treatment, extensive tumor burden, and elevated bilirubinemia (>2 g/dL) are identified risk factors of REILD [ 97 , 102 , 103 , 104 , 105 , 106 ].…”

Section: Selective Internal Radiation Therapy (Sirt)mentioning

confidence: 99%

“…Mortality of REILD may reach up to 30% [ 102 ]. A radiation dose-to-liver volume ratio >0.8 GBq/L, an elevated dose to normal liver (>50 Gy), pre-existing liver disease, previous chemotherapy, whole liver treatment, extensive tumor burden, and elevated bilirubinemia (>2 g/dL) are identified risk factors of REILD [ 97 , 102 , 103 , 104 , 105 , 106 ]. The liver complication rate could change between different devices available, but no comparative studies were performed with this goal [ 94 , 107 ].…”

Section: Selective Internal Radiation Therapy (Sirt)mentioning

confidence: 99%

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The Role of Interventional Radiology for the Treatment of Hepatic Metastases from Neuroendocrine Tumor: An Updated Review

Barat

Cottereau

Kedra

et al. 2020

JCM

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Interventional radiology plays an important role in the management of patients with neuroendocrine tumor liver metastasis (NELM). Transarterial embolization (TAE), transarterial chemoembolization (TACE), and selective internal radiation therapy (SIRT) are intra-arterial therapies available for these patients in order to improve symptoms and overall survival. These treatment options are proposed in patients with NELM not responding to systemic therapies and without extrahepatic progression. Currently, available data suggest that TAE should be preferred to TACE in patients with NELM from extrapancreatic origin because of similar efficacy and better patient tolerance. TACE is more effective in patients with pancreatic NELM and SIRT has shown promising results along with good tolerance. However, large randomized controlled trials are still lacking in this setting. Available literature mainly consists in small sample size and retrospective studies with important technical heterogeneity. The purpose of this review is to provide an updated overview of the currently reported endovascular interventional radiology procedures that are used for the treatment of NELM.

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“…70 Another consideration for patients with long life expectancy is radioembolization-induced chronic hepatic toxicity (RECHT), manifesting as clinical liver failure in the absence of tumor progression in 10 to 20% of patients surviving whole-liver radioembolization for more than 2 years. [71][72][73] The time from treatment to evaluation of response can create anxiety, as patients wait to determine if a treatment has been successful. Often, the intensity and rapidity of followup imaging can make a difference to the patient's decision.…”

Section: Treatment and Patient Factorsmentioning

confidence: 99%

Interventional Oncology Approach to Hepatic Metastases

O’Leary

Soulen

Shamimi-Noori

2020

Semin intervent Radiol

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Metastatic liver disease is one of the major causes of cancer-related morbidity and mortality. Locoregional therapies offered by interventional oncologists alleviate cancer-related morbidity and in some cases improve survival. Locoregional therapies are often palliative in nature but occasionally can be used with curative intent. This review will discuss important factors to consider prior to palliative and curative intent treatment of metastatic liver disease with locoregional therapy. These factors include those specific to the tumor, liver function, liver reserve, differences between treatment modalities, and patient-specific considerations.

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Radioembolization-Induced Chronic Hepatotoxicity: A Single-Center Cohort Analysis

Cited by 49 publications

References 27 publications

Liver-Directed Therapy for Gastroenteropancreatic NETs in the Era of Peptide Receptor Radionuclide Therapy

Liver-Directed Therapy for Gastroenteropancreatic NETs in the Era of Peptide Receptor Radionuclide Therapy

The Role of Interventional Radiology for the Treatment of Hepatic Metastases from Neuroendocrine Tumor: An Updated Review

Interventional Oncology Approach to Hepatic Metastases

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