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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2015; 21(27): 8271-8283
Published online Jul 21, 2015. doi: 10.3748/wjg.v21.i27.8271
Effects of Yttrium-90 selective internal radiation therapy on non-conventional liver tumors
Andrew Kuei, Sammy Saab, Sung-Ki Cho, Stephen T Kee, Edward Wolfgang Lee
Andrew Kuei, Stephen T Kee, Edward Wolfgang Lee, Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, United States
Sammy Saab, Department of Medicine, Division of Hepatology, Pfleger Liver Institute, University of California at Los Angeles, Los Angeles, CA 90024, United States
Sung-Ki Cho, Division of Interventional Radiology, Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: 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/
Correspondence to: Edward Wolfgang Lee, MD, PhD, Division of Interventional Radiology, Department of Radiology, UCLA Medical Center, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 2125 Los Angeles, CA 90024, United States. EdwardLee@mednet.ucla.edu
Telephone: +1-310-2678771
Received: January 5, 2015
Peer-review started: January 5, 2015
First decision: April 13, 2015
Revised: April 29, 2015
Accepted: June 16, 2015
Article in press: June 16, 2015
Published online: July 21, 2015
Processing time: 198 Days and 6.3 Hours
Abstract

The liver is a common site of metastasis, with essentially all metastatic malignancies having been known to spread to the liver. Nearly half of all patients with extrahepatic primary cancer have hepatic metastases. The severe prognostic implications of hepatic metastases have made surgical resection an important first line treatment in management. However, limitations such as the presence of extrahepatic spread or poor functional hepatic reserve exclude the majority of patients as surgical candidates, leaving chemotherapy and locoregional therapies as next best options. Selective internal radiation therapy (SIRT) is a form of catheter-based locoregional cancer treatment modality for unresectable tumors, involving trans-arterial injection of microspheres embedded with a radio-isotope Yttrium-90. The therapeutic radiation dose is selectively delivered as the microspheres permanently embed themselves within the tumor vascular bed. Use of SIRT has been conventionally aimed at treating primary hepatic tumors (hepatocellular carcinoma) or colorectal and neuroendocrine metastases. Numerous reviews are available for these tumor types. However, little is known or reviewed on non-colorectal or non-neuroendocrine primaries. Therefore, the aim of this paper is to systematically review the current literature to evaluate the effects of Yttrium-90 radioembolization on non-conventional liver tumors including those secondary to breast cancer, cholangiocarcinoma, ocular and percutaneous melanoma, pancreatic cancer, renal cell carcinoma, and lung cancer.

Keywords: Liver metastases, Breast cancer, Melanoma, Cholangiocarcinoma, Radioembolization, Selective internal radiation therapy, Selective internal radiation therapy, Transarterial radioembolization, Transarterial radioembolization, Yttrium-90

Core tip: Selective internal radiotherapy or transarterial radioembolization with Yttrium-90 microspheres is a targeted catheter-based therapy indicated for unresectable metastatic liver tumors. A number of reviews and meta-analyses have been written on the use of Yttrium-90 in the treatment of liver metastases, however few broadly investigate results from non-colorectal or non-neuroendocrine primaries. Our objective is to consolidate the current literature to better delineate the response and survival outcomes of Yttrium-90 radioembolization on non-conventional liver tumors including breast cancer, cholangiocarcinoma, ocular and percutaneous melanoma, pancreatic cancer, renal cell carcinoma and lung cancer.