Patient Selection and Activity Planning Guide for Selective Internal Radiotherapy With Yttrium-90 Resin Microspheres
- Faculty of Medicine, Chinese University of Hong Kong, Shatin, New Territories (Hong Kong)
- Wake Radiology Oncology, Cary, NC (United States)
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)
- Nuclear Medicine and PET Centre, Mount Elizabeth Hospital, Singapore (Singapore)
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan (China)
- Comprehensive Oncology Centre, Hong Kong Sanatorium and Hospital (Hong Kong)
- Department of Nuclear Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (China)
- Division of Interventional Radiology, Northwestern University, Chicago, IL (United States)
- Liver Unit, Clinica Universitaria de Navarra and Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas, Pamplona (Spain)
- Department of Diagnostic Imaging, National University Hospital, Singapore (Singapore)
- Parker-Hughes Professor of Diagnostic Radiology, University of Sydney, Sydney, NSW (Australia)
Purpose: Selective internal radiotherapy (SIRT) with yttrium-90 ({sup 90}Y) resin microspheres can improve the clinical outcomes for selected patients with inoperable liver cancer. This technique involves intra-arterial delivery of {beta}-emitting microspheres into hepatocellular carcinomas or liver metastases while sparing uninvolved structures. Its unique mode of action, including both {sup 90}Y brachytherapy and embolization of neoplastic microvasculature, necessitates activity planning methods specific to SIRT. Methods and Materials: A panel of clinicians experienced in {sup 90}Y resin microsphere SIRT was convened to integrate clinical experience with the published data to propose an activity planning pathway for radioembolization. Results: Accurate planning is essential to minimize potentially fatal sequelae such as radiation-induced liver disease while delivering tumoricidal {sup 90}Y activity. Planning methods have included empiric dosing according to degree of tumor involvement, empiric dosing adjusted for the body surface area, and partition model calculations using Medical Internal Radiation Dose principles. It has been recommended that at least two of these methods be compared when calculating the microsphere activity for each patient. Conclusions: Many factors inform {sup 90}Y resin microsphere SIRT activity planning, including the therapeutic intent, tissue and vasculature imaging, tumor and uninvolved liver characteristics, previous therapies, and localization of the microsphere infusion. The influence of each of these factors has been discussed.
- OSTI ID:
- 22055969
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 82, Issue 1; Other Information: Copyright (c) 2012 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
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