Yttrium-90 Radioembolization for Androgen-Independent Prostate Cancer Metastasis to the Liver

This study reports outcomes of patients undergoing transarterial radioembolization (TARE) utilizing yttrium-90 (Y90) for androgen-independent prostate cancer liver metastasis.

A retrospective review was conducted for seven patients treated with TARE between 2007 and January 2024. Index tumor response was described through the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Survival analysis was calculated by the Kaplan-Meier method for index tumor, liver, extra-hepatic, and time-to-progression, as well as overall survival from day of TARE. Adverse events within one month of TARE were evaluated by the Common Terminology Criteria for Adverse Events (CTCAE) version 5.

The median age of our cohort was 60.9 years (range, 52.3-79.2 years). The index tumor was treated with a median dose of 95.0 Gy (range, 28.7-300.7 Gy) and activity of 1.2 GBq (range, 0.7-2.5 GBq). Imaging follow up was completed for 86% (n = 6), with one early death. By RECIST criteria, 50% (n = 3) of patients achieved partial response and 50% (n = 3) of patients had stable disease as their final imaging responses. No index tumor progressed based on the RECIST criteria. Median progression was 2.3 (range, 1.3-6.9), 2.8 (range, 1.3-6.9), and 7.0 (range, 1.3-22.1) months for time-to-, hepatic, and extrahepatic progression, respectively. Median overall survival was 16.2 months (range, 1.0-93.2 months). One patient died within 30 days of the procedure. One patient reported CTCAE grade 3 effect: fatigue (n = 1).

TARE demonstrates antitumor activity and manageable toxicity in androgen-independent prostate cancer liver metastasis. However, optimal treatment timing remains uncertain.