Radiation segmentectomy of hepatic metastases with Y-90 glass microspheres Journal Article

Authors: Kurilova, I.; Bendet, A.; Fung, E. K.; Petre, E. N.; Humm, J. L.; Boas, F. E.; Crane, C. H.; Kemeny, N.; Kingham, T. P.; Cercek, A.; D’Angelica, M. I.; Beets-Tan, R. G. H.; Sofocleous, C. T.
Article Title: Radiation segmentectomy of hepatic metastases with Y-90 glass microspheres
Abstract: Purpose: To evaluate safety and efficacy of radiation segmentectomy (RS) with 90Y glass microspheres in patients with limited metastatic liver disease not amenable to resection or percutaneous ablation. Methods: Patients with ≤ 3 tumors treated with RS from 6/2015 to 12/2017 were included. Target tumor radiation dose was > 190 Gy based on medical internal radiation dose (MIRD) dosimetry. Tumor response, local tumor progression (LTP), LTP-free survival (LTPFS) and disease progression rate in the treated segment were defined using Choi and RECIST 1.1 criteria. Toxicities were evaluated using modified SIR criteria. Results: Ten patients with 14 tumors underwent 12 RS. Median tumor size was 3 cm (range 1.4–5.6). Median follow-up was 17.8 months (range 1.6–37.3). Response rates per Choi and RECIST 1.1 criteria were 8/8 (100%) and 4/9 (44%), respectively. Overall LTP rate was 3/14 (21%) during the study period. One-, two- and three-year LTPFS was 83%, 83% and 69%, respectively. Median LTPFS was not reached. Disease progression rate in the treated segment was 6/18 (33%). Median overall survival was 41.5 months (IQR 16.7–41.5). Median delivered tumor radiation dose was 293 Gy (range 163–1303). One major complication was recorded in a patient post-Whipple procedure who suffered anaphylactic reaction to prophylactic cefotetan and liver abscess in RS region 6.5 months post-RS. All patients were alive on last follow-up. Conclusion: RS of ≤ 3 hepatic segments can safely provide a 2-year local tumor control rate of 83% in selected patients with limited metastatic liver disease and limited treatment options. Optimal dosimetry methodology requires further investigation. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.
Keywords: liver; metastases; vascular; radionuclide therapy; interventional
Journal Title: Abdominal Radiology
Volume: 46
Issue: 7
ISSN: 2366-004X
Publisher: Springer  
Date Published: 2021-07-01
Start Page: 3428
End Page: 3436
Language: English
DOI: 10.1007/s00261-021-02956-6
PUBMED: 33606062
PROVIDER: scopus
Notes: Article -- Export Date: 1 July 2021 -- Source: Scopus
Citation Impact
MSK Authors
  1. T Peter Kingham
    383 Kingham
  2. John Laurence Humm
    381 Humm
  3. Elena Nadia Petre
    66 Petre
  4. Nancy Kemeny
    483 Kemeny
  5. Franz Edward Boas
    68 Boas
  6. Edward Komin Fung
    11 Fung
  7. Christopher   Crane
    95 Crane
  8. Achiude Bendet
    6 Bendet