Toxicity comparison of yttrium-90 resin and glass microspheres radioembolization

To investigate the clinical, hematological and biochemical toxicity differences between glass and resin yttrium-90 (⁹⁰Y)-microspheres radioembolization treatment of primary and metastatic liver disease.

Between May 2014 and November 2016 all consecutive glass and resin ⁹⁰Y microspheres radioembolization treatments were retrospectively analyzed. Biochemical, hematological and clinical data were collected at treatment day, two weeks, one month and three months follow-up. Post-treatment ⁹⁰Y PET/CTs were assessed for the absorbed doses in non-tumorous liver volume (DNTLV) and tumor volume (DTV). Biochemical, hematological and clinical toxicity were compared between glass and resin using chi square tests and repeated ANOVA measures. Biochemical and clinical toxicity was correlated with DNTLV,total by means of Pearson correlation and independent t-tests.

A total of 85 patients were included (N.=44 glass, N.=41 resin). Clinical toxicity the day after treatment (i.e. abdominal pain [P=0.000], nausea [P=0.000] and vomiting [P=0.003]) was more prevalent for resin. Biochemical and hematological toxicities were similar for both microspheres. The DNTLV,total was significantly higher in patients with REILD grade ≥3 in the resin group (43.5 versus 33.3 Gy [P=0.050]). A similar non-significant trend was seen in the glass group: 95.0 versus 69.0 Gy [P=0.144].

The clinical, hematological and biochemical toxicity of radioembolization treatment with glass and resin is comparable, however, post-embolization syndrome related complaints are more common for resin.