Short-term effectiveness of radiochemoembolization for selected hepatic metastases with a combination protocol

Table 3 Studies on Yttrium-90 radioembolization for metastatic hepatic lesions from mixed sources

Study	Procedure	Agent	Absorbed dose or mean activity delivered1	Number of patients	Response criteria	Response measured at (months post treatment)	Response rate	Complications
Blanchard et al[49], 1989	Radioembolization	90Y plastic microspheres	NA	15	WHO	NA	Partial response in 5 (33.3%), minimal response in 2 (13.3%)	Gastritis or gastric ulceration in 6 (in three this was proven to be due to unintended infusion of microspheres into the gastric circulation)
Andrews et al[50], 1994	Radioembolization	90Y glass microspheres	150 Gy	24	WHO	2	Partial response in 5 (20.8%), minimal response in 4 (16.7%), stable disease in 7 (29.2%), progressive disease in 8 (33.3%)	Mild gastrointestinal symptoms in 4 (unrelated to treatment)
Miller et al[7], 2007	Radioembolization	90Y glass microspheres	100-120 Gy	42	WHO	2.32	Complete/partial response in 8 (19%), stable disease in 22 (52%), progressive disease in 23	Radiation cholecystitis in 10, liver edema in 18
					RECIST	3.92	Complete/partial response in 10 (24%), stable disease in 21 (50%), progressive disease in 23
					Necrosis	12	Complete/partial response in 19 (45%)
					Combined	1.12	Complete/partial response in 21 (50%), stable disease in 11 (26%)
Sato et al[8], 2008	Radioembolization	90Y glass microspheres	112.8 Gy/1.83 GBq	137	WHO	1-3	Complete response (2.1%), partial response (40.7%)	Fatigue (56%), vague abdominal pain (26%), nausea (23%)
Lim et al[51], 2005	Radioembolization	90Y resin microspheres	NA	46	RECIST	2	Partial response in 12 (27%), stable disease in 12 (27%), progressive disease in 19 (44%)	Between 2 and 8 wk of lethargy, anorexia, nausea and right upper quadrant pain in most patients, severe gastric/duodenal ulceration in 4 (8%), portal hypertension in 1, radiation hepatitis in 1
Yu et al[52], 2006	Radioembolization	90Y resin microspheres	42 Gy	49	RECIST	NA	Response rate of 29%	Fatigue in 18 (37%), vague abdominal pain in 10 (20%), nausea/vomiting in 10 (20%), ascites and/or leg edema in 3 (6%)
Szyszko et al[53], 2007	Radioembolization	90Y resin microspheres	1.9 GBq	21	RECIST	1-2	Partial response in 2 (13%), stable disease in 9 (60%), progressive disease in 4 (27%)	NA
Stuart et al[54], 2008	Radioembolization	90Y resin microspheres	NA	30	RECIST	NA	Partial response or stable disease in 14 (47%)	Gastrointestinal ulceration in 1 (3%)
Kennedy et al[55], 2009	Radioembolization	90Y resin microspheres	1.1 ± 0.6 GBq	5023	RECIST	3	Complete response in 23 (4.5%), partial response in 48 (9.5%), stable disease in 386 (76.8%), progressive disease in 45 (9%)	Fatigue and upper abdominal pain (29%), gastritis and overt gastric ulceration (2%), severe liver disease (4%)
Peynircioğlu et al[43], 2010	Radioembolization	90Y resin microspheres	1.24 GBq	10	RECIST	1-2	All patients had at least partial response of the target lesions	Post-procedural mild to moderate fatigue in all patients for 7 d, with mild to moderate fever and abdominal pain in some patients
Omed et al[56], 2010	Radioembolization	90Y resin microspheres	NA	11	RECIST	NA	Partial response (20%), stable disease (50%), progressive disease (30%)	No major complications, 82% of patients experienced side-effects, mainly nausea, vomiting and abdominal pain
Cianni et al[57], 2010	Radioembolization	90Y resin microspheres	1.64 Gbq	110	RECIST	2	Complete/partial response in 45, stable disease in 42, progressive disease in 23	Hepatic failure in 1, gastritis in 6, cholecystitis in 2

¹The absorbed dose in Gy and/or the mean delivered activity in Gbq are provided with respect to their availability;

²median;

³the total number of patients in the study was 680, but the response evaluation criteria in solid tumor (RECIST) criteria were only available for 502 patients. ⁹²Y: Yttrium-90; WHO: World Health Organization; NA: Not available.