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90Y-microsphere radioembolization: The method, clinical evidence and perspective
Trifon Spyridonidis1, Nikolaos Papathanasiou, John Spyridonidis
1Nuclear Medicine & PET/CT Department, University Hospital of Patras, Rio, Patras, Greece. nikopapath@googlemail.com.
Hellenic Journal of Nuclear Medicine
|December 11, 2020
Summary
Yttrium-90 (90Y)-microspheres radioembolization is a liver cancer treatment. While not improving overall survival in hepatocellular carcinoma compared to sorafenib, it offers benefits in specific patient groups with fewer side effects.
Area of Science:
- Interventional Radiology
- Nuclear Medicine
- Oncology
Background:
- Radioembolization delivers radioactive microspheres to liver tumors.
- It is a loco-regional therapy for liver malignancies.
Purpose of the Study:
- To review the procedural steps and clinical evidence for 90Y-microspheres radioembolization.
- To explore its applications in various liver cancers and other neoplasms.
Main Methods:
- Patient selection, angiographic workup, simulation scintigraphy, dosimetry, treatment, and post-treatment imaging.
- Review of prospective, randomized controlled trials and data on other neoplasms.
Main Results:
- Radioembolization is used in advanced hepatocellular carcinoma (HCC) and metastatic colon cancer.
- No overall survival benefit over sorafenib in HCC, but subgroup benefits and a favorable toxicity profile.
- Tumoral liver responses in metastatic colon cancer without overall survival benefit.
Conclusions:
- Ongoing trials aim to define radioembolization's role in treatment algorithms and identify optimal patient subgroups.
- Further research is needed to determine combinations with systemic and targeted therapies.
