Rodríguez-Lago I, Carretero C, Herráiz M, Subtil JC, Betés M, Rodríguez-Fraile M, Sola JJ, Bilbao JI, Muñoz-Navas M, Sangro B. Long-term follow-up study of gastroduodenal lesions after radioembolization of hepatic tumors. World J Gastroenterol 2013; 19(19): 2935-2940 [PMID: 23704826 DOI: 10.3748/wjg.v19.i19.2935]
Corresponding Author of This Article
Cristina Carretero, MD, Endoscopy Unit, Department of Gastroenterology, University of Navarra Clinic, Avenida Pio XII 36, 31008 Pamplona, Navarra, Spain. ccarretero@unav.es
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Brief Article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 21, 2013; 19(19): 2935-2940 Published online May 21, 2013. doi: 10.3748/wjg.v19.i19.2935
Long-term follow-up study of gastroduodenal lesions after radioembolization of hepatic tumors
Iago Rodríguez-Lago, Cristina Carretero, Maite Herráiz, José C Subtil, Maite Betés, Macarena Rodríguez-Fraile, Jesús J Sola, José I Bilbao, Miguel Muñoz-Navas, Bruno Sangro
Iago Rodríguez-Lago, Cristina Carretero, Maite Herráiz, José C Subtil, Maite Betés, Miguel Muñoz-Navas, Endoscopy Unit, Department of Gastroenterology, University of Navarra Clinic, 31008 Pamplona, Navarra, Spain
Macarena Rodríguez-Fraile, Department of Nuclear Medicine, University of Navarra Clinic, 31008 Pamplona, Navarra, Spain
Jesús J Sola, Department of Pathology, University of Navarra Clinic, 31008 Pamplona, Navarra, Spain
José I Bilbao, Department of Radiology, University of Navarra Clinic, 31008 Pamplona, Navarra, Spain
Bruno Sangro, Liver Unit, University of Navarra Clinic, 31008 Pamplona, Navarra, Spain
Bruno Sangro, National Biomedical Research Centre Network for Hepatic and Digestive Diseases, 08036 Barcelona, Cataluña, Spain
Author contributions: Rodríguez-Lago I, Carretero C and Sangro B designed the study and wrote the manuscript; Carretero C, Herráiz M, Subtil JC, Betés M and Muñoz-Navas M performed the endoscopic studies; Bilbao JI performed the treatments; Rodríguez-Fraile M performed the gammagraphic evaluation before and after the radioembolization treatment; Sola JJ was responsible for the histopathologic studies.
Correspondence to: Cristina Carretero, MD, Endoscopy Unit, Department of Gastroenterology, University of Navarra Clinic, Avenida Pio XII 36, 31008 Pamplona, Navarra, Spain. ccarretero@unav.es
Telephone: +34-948-255400 Fax: +34-948-296500
Received: November 6, 2012 Revised: January 18, 2013 Accepted: February 2, 2013 Published online: May 21, 2013 Processing time: 195 Days and 1.7 Hours
Abstract
AIM: To evaluate the long-term natural history of the gastroduodenal lesions secondary to extrahepatic embolization with Ytrium 90 (90Y) spheres.
METHODS: From September 2003 to January 2012, 379 procedures of liver radioembolization (RE) using resin microspheres loaded with 90Y were performed in our center. We have retrospectively compiled the data from 379 RE procedures performed in our center. We report a comprehensive clinical, analytical, endoscopic and histologic long-term follow-up of a series of patients who developed gastroduodenal lesions after the treatment.
RESULTS: Six patients (1.5%) developed gastrointestinal symptoms and had gastrointestinal lesions as shown by upper endoscopy in the next 12 wk after RE. The mean time between RE and the appearance of symptoms was 5 wk. Only one patient required endoscopic and surgical treatment. The incidence of gastrointestinal ulcerations was 3.75% (3/80) when only planar images were used for the pre-treatment evaluation. It was reduced to 1% (3/299) when single-photon emission computed tomography (SPECT) images were also performed. The symptoms that lasted for a longer time were nausea and vomiting, until 25 mo after the treatment.
CONCLUSION: All patients were free from severe symptoms at the end of follow-up. The routine use of SPECT has decreased the incidence of gastrointestinal lesions due to unintended deployment of 90Y particles.
