Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-24T11:26:42.408Z Has data issue: false hasContentIssue false
  • English
  • Français

Local experience in Saudi Arabia of selective internal radiation therapy with yttrium-90 microspheres for the treatment of unresectable liver tumours

Published online by Cambridge University Press:  29 April 2019

Bedoor Al Omran  and
Nazar Hamour
Bedoor Al Omran*
Affiliation:
Radiology Department, Bahrain Defence Forces & Royal Medical Services, Riffa, Bahrain
Nazar Hamour
Affiliation:
Radiology Department, King Fahad Specialist Hospital Dammam, Dammam, Kingdom of Saudi Arabia
*
Author for correspondence: Bedoor Al Omran, Bahrain Defence Forces & Royal Medical Services, Riffa, Bahrain. Tel: +973 34465518. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

To assess local experience in Saudi Arabia of the effectiveness and tolerability of selective internal radiation therapy (SIRT) in patients with liver tumours.

Materials and methods:

In a retrospective study, patients with unresectable liver tumours treated with yttrium-90-labelled resin microspheres (SIR-Spheres®, Sirtex, Australia) at the King Fahad Specialist Hospital Dammam (KFSHD) were followed up for at least 12 months, or until death. Data were extracted from medical records. The primary outcome measure was overall survival (OS). Tumour response was recorded using the modified Response Evaluation Criteria in Solid Tumors (mRECIST): tumour control (TC) was defined as the proportion of patients with stable disease (SD), partial response (PR) and complete response (CR).

Results:

A total of 30 patients (21 males, 9 females) with hepatocellular carcinoma (76⋅7%), metastatic colorectal cancer (13⋅3%), cholangiocarcinoma (6⋅7%) or carcinoid tumour (3⋅3%) were evaluated. Mean OS was 16⋅98 months. Eighty-five percent of patients showed TC, 35% had SD, 15% a PR and 35% a CR. No severe complications were observed. Four deaths were considered unrelated to treatment.

Findings:

In this cohort, SIRT showed similar efficacy to that in other studies, with an acceptable tolerability profile. SIRT appears a feasible procedure for liver tumour treatment in the KFSHD.

Keywords

cholangiocarcinoma hepatocellular carcinomaliver tumoursmetastatic colorectal cancerselective internal radiation therapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 18 , Issue 4 , December 2019 , pp. 365 - 368
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

SEER Stat Fact Sheets: Colon and Rectum Cancer, 2003–2009. National Cancer Institute, Bethseda, USA. 2013; http://www.seer.cancer.gov/statfacts/html/colorect.html.Google Scholar
Khan, S A, Thomas, H C, Davidson, B R, Taylor-Robinson, S D. Cholangiocarcinoma. Lancet 2005; 366: 1303–1314.10.1016/S0140-6736(05)67530-7CrossRefGoogle ScholarPubMed
Cabbibo, G, Enea, M, Latteri, F, Genco, C, Craxì, A, Cammá, C. Survival of unresectable hepatocellular carcinoma: a meta-analysis of the control arms of 28 randomized trials. J Hepatol 2009; 50: S285.10.1016/S0168-8278(09)60780-7CrossRefGoogle Scholar
Vilgrain, V, Pereira, H, Assenat, E et al. Efficacy and safety of selective internal radiotherapy with yttrium-90 resin microspheres compared with sorafenib in locally advanced and inoperable hepatocellular carcinoma (SARAH): an open-label randomised controlled phase 3 trial. Lancet Oncol 2017; 18: 1624–1636.10.1016/S1470-2045(17)30683-6CrossRefGoogle ScholarPubMed
Chow, P H W, Gandhi, M, Asia-Pacific Hepatocellular Carcinoma Trials Group. Phase III multi-centre open-label randomized controlled trial of selective internal radiation therapy (SIRT) versus sorafenib in locally advanced hepatocellular carcinoma: The SIRveNIB study. J Clin Oncol 2017; 35(Suppl): A4002.10.1200/JCO.2017.35.15_suppl.4002CrossRefGoogle Scholar
Murthy, R, Kamat, P, Nunez, R, Salem, R. Radioembolization of yttrium-90 microspheres for hepatic malignancy. Semin Intervent Radiol 2008; 25: 48–57.10.1055/s-2008-1052306CrossRefGoogle ScholarPubMed
Sirtex Medical Limited. SIR-Spheres® Y-90 resin microspheres (Yttrium-90 microspheres): package insert, 2017.Google Scholar
Carlier, T, Eugène, T, Bodet-Milin, C et al. Assessment of acquisition protocols for routine imaging of Y-90 using PET/CT. EJNMMI Res 2013; 3: 11. doi: 10.1186/2191-1219X-1183-1111.CrossRefGoogle ScholarPubMed
Eisenhauer, E A, Therasse, P, Bogaerts, J et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009; 45: 228–247.10.1016/j.ejca.2008.10.026CrossRefGoogle Scholar
Bhangoo, M S, Karnani, D R, Hein, P N et al. Radioembolization with yttrium-90 microspheres for patients with unresectable hepatocellular carcinoma. J Gastrointest Oncol 2015; 6: 469–478.Google ScholarPubMed
Sangro, B, Bilbao, J I, Boan, J et al. Radioembolization using 90Y-resin microspheres for patients with advanced hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 2006; 66: 792–800.10.1016/j.ijrobp.2006.05.065CrossRefGoogle ScholarPubMed
Dancey, J E, Shepherd, F A, Paul, K et al. Treatment of nonresectable hepatocellular carcinoma with intrahepatic 90Y-microspheres. J Nucl Med 2000; 41: 1673–1681.Google ScholarPubMed
Saxena, A, Bester, L, Chua, T C, Chu, F C, Morris, D L. Yttrium-90 radiotherapy for unresectable intrahepatic cholangiocarcinoma: a preliminary assessment of this novel treatment option. Ann Surg Oncol 2010; 17: 484–491.10.1245/s10434-009-0777-xCrossRefGoogle ScholarPubMed
Hoffmann, R T, Paprottka, P M, Schon, A et al. Transarterial hepatic yttrium-90 radioembolization in patients with unresectable intrahepatic cholangiocarcinoma: factors associated with prolonged survival. Cardiovasc Intervent Radiol 2012; 35: 105–116.10.1007/s00270-011-0142-xCrossRefGoogle ScholarPubMed
Mosconi, C, Gramenzi, A, Ascanio, S et al. Yttrium-90 radioembolization for unresectable/recurrent intrahepatic cholangiocarcinoma: a survival, efficacy and safety study. Br J Cancer 2016; 115: 297–302.10.1038/bjc.2016.191CrossRefGoogle ScholarPubMed
Kennedy, A S, Dezarn, W A, McNeillie, P et al. Radioembolization for unresectable neuroendocrine hepatic metastases using resin 90Y-microspheres: early results in 148 patients. Am J Clin Oncol 2008; 31: 271–279.10.1097/COC.0b013e31815e4557CrossRefGoogle ScholarPubMed
Devcic, Z, Rosenberg, J, Braat, A J et al. The efficacy of hepatic 90Y resin radioembolization for metastatic neuroendocrine tumors: a meta-analysis. J Nucl Med 2014; 55: 1404–1410.10.2967/jnumed.113.135855CrossRefGoogle ScholarPubMed
Pardo, F, Sangro, B, Lee, R C et al. The Post-SIR-Spheres Surgery Study (P4S): retrospective analysis of safety following hepatic resection or transplantation in patients previously treated with selective internal radiation therapy with yttrium-90 resin microspheres. Ann Surg Oncol 2017; 24: 2465–2473.10.1245/s10434-017-5950-zCrossRefGoogle ScholarPubMed