1. Radiation segmentectomy of hepatic metastases with Y-90 glass microspheres.
- Author
-
Kurilova, I., Bendet, A., Fung, E. K., Petre, E. N., Humm, J. L., Boas, F. E., Crane, C. H., Kemeny, N., Kingham, T. P., Cercek, A., D'Angelica, M. I., Beets-Tan, R. G. H., and Sofocleous, C. T.
- Subjects
LIVER metastasis ,OVERALL survival ,SURVIVAL rate ,LIVER abscesses ,THERAPEUTICS - Abstract
Purpose: To evaluate safety and efficacy of radiation segmentectomy (RS) with
90 Y glass microspheres in patients with limited metastatic liver disease not amenable to resection or percutaneous ablation. Methods: Patients with ≤ 3 tumors treated with RS from 6/2015 to 12/2017 were included. Target tumor radiation dose was > 190 Gy based on medical internal radiation dose (MIRD) dosimetry. Tumor response, local tumor progression (LTP), LTP-free survival (LTPFS) and disease progression rate in the treated segment were defined using Choi and RECIST 1.1 criteria. Toxicities were evaluated using modified SIR criteria. Results: Ten patients with 14 tumors underwent 12 RS. Median tumor size was 3 cm (range 1.4–5.6). Median follow-up was 17.8 months (range 1.6–37.3). Response rates per Choi and RECIST 1.1 criteria were 8/8 (100%) and 4/9 (44%), respectively. Overall LTP rate was 3/14 (21%) during the study period. One-, two- and three-year LTPFS was 83%, 83% and 69%, respectively. Median LTPFS was not reached. Disease progression rate in the treated segment was 6/18 (33%). Median overall survival was 41.5 months (IQR 16.7–41.5). Median delivered tumor radiation dose was 293 Gy (range 163–1303). One major complication was recorded in a patient post-Whipple procedure who suffered anaphylactic reaction to prophylactic cefotetan and liver abscess in RS region 6.5 months post-RS. All patients were alive on last follow-up. Conclusion: RS of ≤ 3 hepatic segments can safely provide a 2-year local tumor control rate of 83% in selected patients with limited metastatic liver disease and limited treatment options. Optimal dosimetry methodology requires further investigation. [ABSTRACT FROM AUTHOR]- Published
- 2021
- Full Text
- View/download PDF