Yttrium-90 radioembolization in the management of liver tumors: expanding the global experience

Riaz, Ahsun; Salem, Riad

doi:10.1007/s00259-009-1345-0

Cited by 6 publications

(5 citation statements)

References 11 publications

(12 reference statements)

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“…[8][9][10] As the majority of liver metastases derive their blood supply from the hepatic artery, high doses of glass microsphere based irradiation are able to be administered while sparing the non-diseased hepatic parenchyma supported by the portal vein. 11 Transarterial chemoembolization (TACE) also takes advantage of this anatomy to deliver a mixture of emulsified chemotherapy, instilled alongside embolic particles to create drug stasis in the region of disease. Median OS with this method has been reported of up to 4-9 months.…”

Section: Treatment Of Unresectable Melanoma Hepatic Metastasesmentioning

confidence: 99%

Over 12 Years Single Institutional Experience Performing Percutaneous Hepatic Perfusion for Unresectable Liver Metastases

et al. 2020

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Patients with unresectable hepatic metastases, from uveal or ocular melanoma, are challenging to treat with an overall poor prognosis. Although over the past decade significant advances in systemic therapies have been made, metastatic disease to the liver, especially from uveal melanoma, continues to be a poor prognosis. Percutaneous hepatic perfusion (PHP) is a safe, viable treatment option for these patients. PHP utilizes high dose chemotherapy delivered directly to the liver while minimizing systemic exposure and can be repeated up to 6 times. Isolation of the hepatic vasculature with a double-balloon catheter allows for high concentration cytotoxic therapy to be administered with minimal systemic adverse effects. A detailed description of the multidisciplinary treatment protocol used at an institution with over 12 years of experience is discussed and recommendations are given. A dedicated team of a surgical or medical oncology, interventional radiology, anesthesiology and a perfusionist allows PHP to be repeatedly performed as a safe treatment strategy for unresectable hepatic metastases.

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Section: Treatment Of Unresectable Melanoma Hepatic Metastasesmentioning

confidence: 99%

Over 12 Years Single Institutional Experience Performing Percutaneous Hepatic Perfusion for Unresectable Liver Metastases

et al. 2020

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“…In order to insure optimal treatments, radioembolization requires blood flow and perfusion to maximize the therapeutic effect of the treatment. In this therapy, administration of radiopharmaceuticals such as yttrium-90 ( 90 Y) or rhenium-188 ( 188 Re) particles results in a high internal tumoricidal radiation source (up to 4993 Gy), which, when delivered to a targeted area, reduces the risk of causing radiation-induced liver disease and can be imaged using SPECT-CT [9,115–118]. However, while radiopharmaceuticals have been demonstrated to be effective in improving survival in patients with unresectable HCC tumors, few studies have compared them to more traditional TACE embolic agents and further studies are required.…”

Section: Additional Particle-based Drug Delivery Approaches In Tace Andmentioning

confidence: 99%

Advances in image-guided Intratumoral Drug Delivery Techniques

Solorio

Patel

et al. 2010

Therapeutic Delivery

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Image-guided drug delivery provides a means for treating a variety of diseases with minimal systemic involvement while concurrently monitoring treatment efficacy. These therapies are particularly useful to the field of interventional oncology, where elevation of tumor drug levels, reduction of systemic side effects and post-therapy assessment are essential. This review highlights three such image-guided procedures: transarterial chemoembolization, drug-eluting implants and convection-enhanced delivery. Advancements in medical imaging technology have resulted in a growing number of new applications, including image-guided drug delivery. This minimally invasive approach provides a comprehensive answer to many challenges with local drug delivery. Future evolution of imaging devices, image-acquisition techniques and multifunctional delivery agents will lead to a paradigm shift in patient care.

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“…The optimal dosage used for each treatment session and its correlation with a pretreatment SPECT/CT scan to assess the degree of pulmonary shunting 28 was a controversy. There were advocacies demonstrating a safe use of yttrium-90 radioembolization without a pretreatment SPECT scan, 29 so further safety report and cost-efficacy studies were necessary to determine the role of pretreatment SPECT scan and the optimal dosage. There were case series from multiple centres reporting a dramatic drop of alpha-fetoprotein with the use of yttrium-90 radioembolization.…”

Section: Discussionmentioning

confidence: 99%

Update on yttrium‐90‐based radio‐embolization for treatment of hepatocellular carcinoma

Kan

Tsang

Poon

et al. 2012

ANZ Journal of Surgery

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The current use of yttrium-90 radio-embolization was mainly based on small case series. Yttrium-90 radio-embolization seemed equivalent to conventional chemo-embolization in terms of tumour response rate and survival benefit. Emerging evidence suggested that yttrium-90 radio-embolization may have a more favourable side effects profile, in particular in reducing the chance of neutropaenia. Cost and logistics arrangement were two important considerations in generalizing the application of yttrium-90 radio-embolization.

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Yttrium-90 radioembolization in the management of liver tumors: expanding the global experience

Cited by 6 publications

References 11 publications

Over 12 Years Single Institutional Experience Performing Percutaneous Hepatic Perfusion for Unresectable Liver Metastases

Over 12 Years Single Institutional Experience Performing Percutaneous Hepatic Perfusion for Unresectable Liver Metastases

Advances in image-guided Intratumoral Drug Delivery Techniques

Update on yttrium‐90‐based radio‐embolization for treatment of hepatocellular carcinoma

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