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Treatment of liver tumors with yttrium-90 microspheres alone
R J Blanchard1, I M Morrow, J B Sutherland
1Department of Surgery, University of Manitoba, Winnipeg.
Abstract:
Fifteen patients with liver metastases and one patient with hepatoma were treated by infusing 15 microns diameter plastic microspheres containing yttrium-90 into the hepatic artery. Twenty additional patients were screened but were found to be unsuitable for treatment. Follow-up angiography was done in 13 of the 16 treated patients. In five patients there was a reduction in tumor volume by more than 50% and in another two patients there was a smaller reduction. In six patients gastritis or gastric ulceration occurred and in three this was demonstrated to be due to unintended infusion of microspheres into the gastric circulation. For patients treated with yttrium-90 microspheres, mean survival time after referral was 62 weeks and in the untreated group it was 30 weeks, although this difference was not significant. We conclude that yttrium-90 microspheres alone can effect reduction in the size of liver tumors in some patients in whom their use is feasible.
Insights
Yttrium-90 microspheres delivered via hepatic artery infusion showed potential in reducing liver tumor size for some patients. This targeted cancer therapy demonstrated tumor volume reduction and a trend towards improved survival, despite some gastrointestinal side effects.
Area of Science:
- Interventional Radiology
- Oncology
- Nuclear Medicine
Background:
- Liver metastases and primary hepatoma present significant treatment challenges.
- Trans-arterial therapies offer localized treatment options for liver malignancies.
Purpose of the Study:
- To evaluate the efficacy and safety of yttrium-90 microsphere infusion for liver tumors.
- To assess tumor response and survival outcomes in patients treated with this novel approach.
Main Methods:
- 16 patients with liver tumors received hepatic artery infusion of yttrium-90 labeled microspheres (15 microns).
- Follow-up angiography assessed tumor response; survival data compared treated vs. untreated groups.
Main Results:
- Tumor volume reduction >50% observed in 5/13 patients; smaller reductions in 2 others.
- Adverse events included gastritis/ulceration in 6 patients, linked to unintended gastric artery infusion.
- Mean survival was 62 weeks for treated vs. 30 weeks for untreated, though not statistically significant.
Conclusions:
- Yttrium-90 microspheres can achieve tumor size reduction in select liver cancer patients.
- Feasibility and potential efficacy warrant further investigation, with attention to mitigating gastric side effects.