Radioembolization with Yttrium-90 microspheres (SIRT) in pancreatic cancer patients with liver metastases: efficacy, safety and prognostic factors

Oncology. 2014;86(1):24-32. doi: 10.1159/000355821. Epub 2013 Dec 21.

Abstract

Objective: To analyze the clinical efficacy of (90)Y radioembolization in liver metastases from pancreatic cancer, to describe treatment toxicities and to identify biomarkers as predictors of outcome.

Methods: Data from 19 pancreatic cancer patients (9 females/10 males) who had received (90)Y radioembolization for metastatic liver disease between 06/2004 and 01/2011 were analyzed retrospectively.

Results: The median age at (90)Y radioembolization was 63 years (range 43-77). In 16 patients, previous palliative gemcitabine-based chemotherapy was given for metastatic disease. Objective response in the liver after (90)Y radioembolization was 47%. Median local progression-free survival in the liver was 3.4 months (range 0.9-45.0). Median overall survival (OS) was 9.0 months (range 0.9-53.0) and 1-year survival was 24%. Cox regression models for baseline biomarkers at (90)Y radioembolization revealed correlations of increased carbohydrate antigen 19-9 (p = 0.02) and C-reactive protein (p = 0.03) with shorter OS. Short-term adverse events (nausea, vomiting, fatigue, fever and abdominal pain) did not exceed grade 3. As long-term adverse events, liver abscesses, gastroduodenal ulceration, cholestasis and cholangitis, ascites and spleen infarction were observed.

Conclusion: (90)Y radioembolization is able to induce an encouraging local response rate of liver metastases of pancreatic cancer patients. Most short-term toxicities are manageable; however, patients should be followed up carefully for severe long-term toxicities.

MeSH terms

  • Adult
  • Aged
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / radiotherapy*
  • Liver Neoplasms / secondary*
  • Male
  • Microspheres*
  • Middle Aged
  • Pancreatic Neoplasms / pathology*
  • Proportional Hazards Models
  • Retrospective Studies
  • Yttrium Radioisotopes / administration & dosage*
  • Yttrium Radioisotopes / adverse effects

Substances

  • Yttrium Radioisotopes