Selective internal radiation therapy with 90y microspheres for liver metastases: single-centre experience

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1 Selective internal radiation therapy with 90y microspheres for liver metastases: single-centre experience Poster No.: C-0718 Congress: ECR 2011 Type: Scientific Exhibit Authors: A. Presidente, G. Lombardi, R. D'Angelo, C. Arrichiello, L. Aloj, F. Fiore; napoli/it Keywords: DOI: Interventional non-vascular, Liver, Oncology, Catheter arteriography, CT-Angiography, PET-CT, Chemoembolisation, Radioembolisation, Metastases, Neoplasia /ecr2011/C-0718 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 8

2 Purpose Assessment of safety and effectiveness of intra-arterial Y 90 SIR - spheres treatment in patients with liver metastasis Methods and Materials Between 2005 and 2010 radioembolization was performed in 60 patients with non surgical liver metastases in progression after chemiotherapy : 38 with colorectal tumor; 13 with breast cancer; 4 with melanoma; 2 with NET; 1 with pancreas tumor; 1 with gastric tumor; 1 with ovarian tumor. The administered dose was calculated with Body Surface Area Method (BSA). All patients underwent to PET/TC before and after treatment. PET-Y90 was performed to check the microspheres distribution. Work up included also embolization of Gastroduodenal artery and other arteries using micro coils. Shunting study was performed with TC 99MAA after positioning of 3French microcatheter. Images for this section: Page 2 of 8

3 Fig. 1: Angiography of coeliac tripod that shows a basket vascularization of metastatic lesion Page 3 of 8

4 Fig. 2: Angiography :Arterial-venous phase that shows an ipervascolar rim of the lesion Page 4 of 8

5 Results The mean administered dose was 1.55 GBq. The partial/complete response was achieved in 21 patients; in 22 was obtained stability and progressive disease in 17 patients. No significant side-effects treatment were observed; 37 patients developed fever and can last up to a week. 23 patients also experienced abdominal pain controlled by oral analgesia. Prophylaxis treatment was used for 1 month after with PPI. Images for this section: Fig. 1: Patient affected by Colorectal Cancer and breast cancer,with colorectal liver metastasis, judged unresectable. MDCT pre-treatment shows an ipodense lesion with peripheral enhancement tipical of colorectal liver metastasis. Page 5 of 8

6 Fig. 2: MDCT, after two months by colorectal liver metastasis radioembolization, shows a partial response (RECIST) with reduction of unity of densitometry (HU). Page 6 of 8

7 Fig. 3: MDCT shows, after one year by colorectal liver metastasis treatment, with a partial response confirmed. He currently doesn't show liver desease at three years follow up. Page 7 of 8

8 Conclusion Our experience suggests that radioembolization is effective and safe for local treatment of not surgical hepatic metastasis in progression after systemic Chemotherapy. References Radioembolization (SIRT) of hepatic lesions with Y90 resinmicrospehres Fiore F. MD. A journal of experimental and clinical oncology;vol 10, number 2, November 2010, R67-R69. Multi-centre phase II clinical trial of yttrium-90 resin microspheres alone in unresectable, chemoterapy refractory colorectal liver metastases M Cosimelli, R. Golfieri, PP Cagol, L. Carpanese, R. Sciuto, CL Maini, R. Mancini, I. Sperduti, G.Pizzi, MG. Diodoro, M Perrone, E Giampalma, B Angelelli, F.Fiore, S Lastoria, S Bacchetti, D Gasperini, O Geatti and F Izzo; British Journal Cancer (2010), 1-8 Radioembolization of Liver tumors With Yttrium-90 Microsphere Hojjat Ahmadzadehfar, MD, Hans-Jürgen Biersack, MD, PhD, and Samer Ezziddin, MD, Semin Nucl Med; 40: Elsevier Inc. Clinical care and technical recommendations formicrosphere treatment of liver cancer 90yttrium S-C Wang, L Bester, JP Burnes, JE Clouston, TJ Hugh, AF Little, RTA Padbury and D Price.Journal of Medical Imaging and Radiation Oncology;54 (2010) Personal Information Page 8 of 8