L Bester MBChB, BSc (Hons), MMedRad, MFGP, FRANZCR, FACP; B Meteling BvetMed, PhD; N Pocock MD, FRACP; A Saxena BmedSc; TC Chua BScMed (Hons), MBBS; DL Morris MD, PhD, FRCS, FRACS.
Medical Imaging—Radiation Oncology—Original Article
Radioembolisation with Yttrium-90 microspheres: An effective treatment modality for unresectable liver metastases
Article first published online: 9 OCT 2012
© 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists
Journal of Medical Imaging and Radiation Oncology
Volume 57, Issue 1, pages 72–80, February 2013
How to Cite
Bester, L., Meteling, B., Pocock, N., Saxena, A., Chua, T. C. and Morris, D. L. (2013), Radioembolisation with Yttrium-90 microspheres: An effective treatment modality for unresectable liver metastases. Journal of Medical Imaging and Radiation Oncology, 57: 72–80. doi: 10.1111/j.1754-9485.2012.02459.x
Conflict of interest: Lourens Bester is a paid consultant for Sirtex Medical Ltd, Sydney, Australia. None of the other authors have identified a conflict of interest.
- Issue published online: 4 FEB 2013
- Article first published online: 9 OCT 2012
- Manuscript Received: 21 NOV 2012
- Manuscript Accepted: 11 JUN 2012
- colorectal cancer;
- liver metastasis;
- Yttrium-90 microspheres
To compare the outcomes (survival and adverse events) of the authors' use of 90Y microsphere radioembolisation in patients with chemotherapy-refractory liver metastases with published data from other groups using radioembolisation. To retrospectively evaluate the efficiency, in particular survival benefits, of radioembolisation in the treatment of liver metastases.
Methods and Materials
Over 5 years, 339 patients underwent 90Y microsphere radioembolisation for unresectable liver metastases and were evaluated for adverse events at the time of treatment and 1 and 3 months after treatment. Overall survival (OS) was calculated by the Kaplan–Meier method. The results from the present retrospective study were compared with a number of prospective and retrospective clinical trials which have addressed the use of 90Y microspheres as a salvage treatment for liver metastases.
The OS time of the present study (12.0 months) compares favourably with survival times reported by other groups. The incidence of late grade 2 adverse events (e.g. duodenal or gastric ulceration, radiation-induced liver disease, gall bladder complications) is comparable to previous studies, with a lower prevalence of grade 2/3 ulcerations (3.7%) at our centre.
The survival results, together with the low acute and late toxicity observed in our data and previous studies, support the use of radioembolisation to aid in the local control of unresectable liver metastases in the salvage setting. The present study contributes to the growing evidence for efficiency, in particular survival gains, of radioembolisation in the treatment of liver metastases.