Treatment Parameters and Outcome in 680 Treatments of Internal Radiation With Resin {sup 90}Y-Microspheres for Unresectable Hepatic Tumors

Journal Article · Sat Aug 01 00:00:00 EDT 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.10.005· OSTI ID:21276949

McNeillie, Patrick M.S. ^[1]; Dezarn, William A ^[2]; Nutting, Charles ^[3]; Sangro, Bruno ^[4]; Wertman, Dan ^[5]; Garafalo, Michael ^[6]; Liu, David ^[7]; Coldwell, Douglas ^[8]; Savin, Michael ^[9]; Jakobs, Tobias ^[10]; Rose, Steven ^[11]; Warner, Richard ^[12]; Carter, Dennis ^[3]; Sapareto, Stephen ^[13]; Nag, Subir ^[14]; Gulec, Seza ^[15]; Calkins, Allison ^[16]; Gates, Vanessa L; Salem, Riad ^[17]

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1. University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC (United States)
2. Wake Radiology Oncology, Cary, NC (United States)
3. Skyridge Medical Center, Denver, CO (United States)
4. Universidad de Navarra and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd), Pamplona (Spain)
5. Durham Regional Medical Center, Durham, NC (United States)
6. University of Maryland School of Medicine, Baltimore, MD (United States)
7. St. Vincent's Hospital, Portland, OR (United States)
8. University of Texas, Dallas, TX (United States)
9. Wm. Beaumont Hospital, Royal Oak, MI (United States)
10. University of Munich-Grosshadern Campus, Munich (Germany)
11. University of California, San Diego, San Diego, CA (United States)
12. Mt. Sinai Medical Center, New York, NY (United States)
13. Banner Good Samaritan Medical Center, Phoenix, AZ (United States)
14. Ohio State University Medical Center, Columbus, OH (United States)
15. Goshen Medical Center, Goshen, IN (United States)
16. St. Joseph's Hospital Cancer Institute, Tampa, FL (United States)
17. Northwestern Medical Center, Chicago, IL (United States)

Purpose: Radioembolization (RE) using {sup 90}Y-microspheres is an effective and safe treatment for patients with unresectable liver malignancies. Radiation-induced liver disease (RILD) is rare after RE; however, greater understanding of radiation-related factors leading to serious liver toxicity is needed. Methods and Materials: Retrospective review of radiation parameters was performed. All data pertaining to demographics, tumor, radiation, and outcomes were analyzed for significance and dependencies to develop a predictive model for RILD. Toxicity was scored using the National Cancer Institute Common Toxicity Criteria Adverse Events Version 3.0 scale. Results: A total of 515 patients (287 men; 228 women) from 14 US and 2 EU centers underwent 680 separate RE treatments with resin {sup 90}Y-microspheres in 2003-2006. Multifactorial analyses identified factors related to toxicity, including activity (GBq) Selective Internal Radiation Therapy delivered (p < 0.0001), prescribed (GBq) activity (p < 0.0001), percentage of empiric activity (GBq) delivered (p < 0.0001), number of prior liver treatments (p < 0.0008), and medical center (p < 0.0001). The RILD was diagnosed in 28 of 680 treatments (4%), with 21 of 28 cases (75%) from one center, which used the empiric method. Conclusions: There was an association between the empiric method, percentage of calculated activity delivered to the patient, and the most severe toxicity, RILD. A predictive model for RILD is not yet possible given the large variance in these data.

• OSTI ID: 21276949
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 74, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2008.10.005; PII: S0360-3016(08)03563-3; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
DOSIMETRY
LIVER
MICROSPHERES
NEOPLASMS
PATIENTS
RADIOTHERAPY
RESINS
TOXICITY
YTTRIUM 90