Yttrium-90 radiation segmentectomy for hepatic metastases: A multi-institutional study of safety and efficacy

Siddharth A. Padia, Guy E. Johnson, Vatche G. Agopian, Joseph DiNorcia, Ravi N. Srinivasa, James Sayre, David S. Shin

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Background and Objectives: This study assessed the outcomes of Yttrium-90 (90Y) radiation segmentectomy for hepatic metastases unamenable to resection or ablation. Materials and Methods: Over 6 years, 36 patients with 53 tumors underwent segmental radioembolization. Patients were not candidates for surgical resection or thermal ablation. Malignancies included metastases from colorectal cancer (31%), neuroendocrine tumors (28%), sarcoma (19%), and others (22%). Eighty-one percent of patients had undergone prior treatment with systemic chemotherapy. Ongoing systemic chemotherapy was continued. Toxicity, tumor response, tumor progression, and survival were assessed. Results: The median tumor size was 3.6 cm (range 1.2–6.1 cm). Adverse event rates were low, with no hepatic-related Common Terminology Criteria for Adverse Events Grade 3 or 4 toxicity. Target tumor Response Evaluation Criteria in Solid Tumors disease control rate was 92% (28% partial response, 64% stable disease). For patients with enhancing tumors (n = 14), modified Response Evaluation Criteria in Solid Tumors target tumor objective response rate was 100%. During a median follow-up of 12 months, target tumor progression occurred in 28% of treated tumors. Overall survival was 96% and 83% at 6 and 12 months, respectively. Conclusions: 90Y radiation segmentectomy for hepatic metastases demonstrates high rates of tumor control and minimal toxicity. Radiation segmentectomy should be considered for patients with metastatic hepatic malignancy who are not candidates for surgical resection.

Original languageEnglish
Pages (from-to)172-178
Number of pages7
JournalJournal of Surgical Oncology
Volume123
Issue number1
DOIs
StatePublished - Jan 2021
Externally publishedYes

Keywords

  • hepatic metastases
  • liver metastases
  • radioembolization

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