Radiofrequency ablation after selective internal radiation therapy with Yttrium90 microspheres in metastatic liver disease-Is it feasible?

Abstract

This retrospective study analyzes, whether patients suffering from extensive hepatic metastatic disease treated with SIRT can become suitable candidates for RFA.Within 38 months 46 patients (26 female, 20 male; age 32-75 years) bearing an extensive hepatic metastatic disease were treated with SIRT. Patients suffered from metastases of breast cancer (16/46), colorectal cancer (CRC) (21/46), neuroendocrine (3/46), and other primary carcinomas (6/46). The indication for SIRT was otherwise untreatable metastases confined to the liver. Forty-three patients received single-session whole-liver radioembolization treatment using Yttrium90 resin microspheres with a mean activity of 2.13GBq. In 1 patient SIRT was confined to the left and in 2 patients to the right liver lobe. In 3 patients major complications (2/3 gastric ulceration and 1/3 oedematous pancreatitis) and in 24 patients minor complications occurred (acute abdominal/epigastric pain and/or nausea). Follow-up CT and/or MRI were obtained in 44 of 46 patients. In 5 of 44 patients tumor load decreased substantially (3/5 breast cancer, 1/5 CRC and 1/5 pancreatic cancer) making RFA feasible. The patients were referred for RFA after the first 3-month follow-up. RFA of the liver was successful in all cases in terms of complete ablation. In selected patients radioembolization is able to downstage liver metastases to an extent making a subsequent RFA suitable and therefore allows increasing the number of patients with a "complete response" after a minimally invasive therapy.

• Authors: R T Hoffmann, T F Jakobs, C H Kubisch, H J Stemmler, C Trumm, K Tatsch, T K Helmberger, M F Reiser
• Journal: European journal of radiology (Eur J Radiol) Vol. 74 Issue 1 Pg. 199-205 (Apr 2010) ISSN: 1872-7727 [Electronic] Ireland
• PMID: 19269763 (Publication Type: Journal Article)
• Copyright: Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Yttrium Radioisotopes

Topics

• Adult
• Aged
• Breast Neoplasms (physiopathology)
• Carcinoma, Neuroendocrine (physiopathology)
• Catheter Ablation
• Colorectal Neoplasms (physiopathology)
• Female
• Humans
• Liver Neoplasms (radiotherapy, secondary)
• Male
• Microspheres
• Middle Aged
• Retrospective Studies
• Yttrium Radioisotopes