Initial Outcome after Selective Intraarterial Radionuclide Therapy with Yttrium-90 Microspheres as Salvage Therapy for Unresectable Metastatic Liver Disease

Purpose: The aim of the study was to retrospectively evaluate the potential benefit on survival outcomes of selective intraarterial radionuclide therapy (SIRT) with Yttrium-90 microspheres as a salvage therapy in liver metastasis of different tumors. Material and Methods: Sixty-one patients who had unresectable liver metastases from colorectal carcinoma (n=23), neuroendocrine tumor (NET; n=12), cholangiocarcinoma (n=9), and others (n=17) received yttrium-90 microspheres. All patients were treated in a salvage setting with an 11-month mean follow-up. Early metabolic treatment response was evaluated by 18F-Fluorodeoxyglucose positron emission tomography (FDG PET-CT) in the sixth week after treatment. Results: Of the 61 patients, 32 were alive at the end of the study; median overall survival (OS) was 17.0±2.5 months (95% confidence interval: 11.9-22.0). A subset analysis of colorectal and noncolorectal groups demonstrated median OS rates of 14.0±5.8 and 17.0±4.8 months, respectively (p=0.543). The mean OS for patients with NET and cholangiocarcinoma was 29.0±3.1 months and 17.7±3.2 months, respectively (p=0.010). According to the early metabolic treatment response, the mean OS of responder and nonresponder groups was 32.0±5.6 months and 11.4±2.1 months, respectively (p=0.054). Eastern Cooperative Oncology Group performance status <1 (p=0.018) and chemotherapy-naive patients (p=0.008) showed significant correlation with survival. Conclusion: SIRT is an effective treatment option for patients with metastatic liver disease in a salvage setting with acceptable toxicity. © Copyright 2013, Mary Ann Liebert, Inc. 2013.