Application and progress of Yttrium-90 therapy in liver malignant tumors

Abstract

Abstract: Liver malignant tumor includes primary liver cancer and liver metastatic cancer. Liver malignant tumor has the characteristics of high malignancy and high mortality. At present, for patients with advanced liver malignant tumors, local treatment is an important treatment method to control the progression of the disease. Yttrium-90 (⁹⁰Y) radiation microspheres are derived from the traditional transarterial chemoembolization (TACE) treatment technology and combined with the tumor short-range precision radiotherapy technology. Compared with traditional TACE treatment, ⁹⁰Y has the characteristics of high tumor response rate, low adverse response and better quality of life. This article reviews the application progress of ⁹⁰Y therapy in liver malignant tumors.

Key words: Yttrium-90, Interventional radiology, Selective internal radiation therapy, Liver cancer

Niu Huimin, Wang Zhiheng, Gao Shixin, Zeng Qian, Li Yinghui, Han Yue. Application and progress of Yttrium-90 therapy in liver malignant tumors[J]. Electronic Journal of Liver Tumor, 2021, 8(4): 36-40.

References

[1] SUNG H, FERLAY J, SIEGEL R L, et al.Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249.
[2] HESKETH R L, ZHU A X, OKLU R.Radiomics and circulating tumor cells: personalized care in hepatocellular carcinoma?[J]. Diagn Interv Radiol, 2015, 21(1): 78-84.
[3] HESKETH R L, ZHU A X, OKLU R.Hepatocellular carcinoma: can circulating tumor cells and radiogenomics deliver personalized care?[J]. Am J Clin Oncol, 2015, 38(4): 431-436.
[4] CHEN W, ZHENG R, BAADE P D, et al.Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132.
[5] VILLANUEVA A.Hepatocellular Carcinoma[J]. N Engl J Med, 2019, 380(15): 1450-1462.
[6] MARTIN J, PETRILLO A, SMYTH E C, et al.Colorectal liver metastases: Current management and future perspectives[J]. World J Clin Oncol, 2020, 11(10): 761-808.
[7] CHAUHAN N, MULCAHY M F, SALEM R, et al.TheraSphere Yttrium-90 Glass Microspheres Combined With Chemotherapy Versus Chemotherapy Alone in Second-Line Treatment of Patients With Metastatic Colorectal Carcinoma of the Liver: Protocol for the EPOCH Phase 3 Randomized Clinical Trial[J]. JMIR Res Protoc, 2019, 8(1): e11545.
[8] ANDREWS J C, WALKER S C, ACKERMANN R J, et al.Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up[J]. J Nucl Med, 1994, 35(10): 1637-1644.
[9] DANCEY J E, SHEPHERD F A, PAUL K, et al.Treatment of nonresectable hepatocellular carcinoma with intrahepatic ⁹⁰Y-microspheres[J]. J Nucl Med, 2000, 41(10): 1673-1681.
[10] HOULE S, YIP T K, SHEPHERD F A, et al.Hepatocellular carcinoma: pilot trial of treatment with Y-90 microspheres[J]. Radiology, 1989, 172(3): 857-860.
[11] BIEDERMAN D M, TITANO J J, TABORI N E, et al. Outcomes of Radioembolization in the Treatment of Hepatocellular Carcinoma with Portal Vein Invasion: Resin versus Glass Microspheres[J]. J Vasc Interv Radiol, 2016, 27(6): 812-821.e812.
[12] KIM H C.Radioembolization for the treatment of hepatocellular carcinoma[J]. Clin Mol Hepatol, 2017, 23(2): 109-114.
[13] SANGRO B, CARPANESE L, CIANNI R, et al.Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma across Barcelona clinic liver cancer stages: a European evaluation[J]. Hepatology, 2011, 54(3): 868-878.
[14] SALEM R, LEWANDOWSKI R, ROBERTS C, et al.Use of Yttrium-90 glass microspheres (TheraSphere) for the treatment of unresectable hepatocellular carcinoma in patients with portal vein thrombosis[J]. J Vasc Interv Radiol, 2004, 15(4): 335-345.
[15] SALEM R, JOHNSON G E, KIM E, et al.Yttrium-90 Radioembolization for the Treatment of Solitary, Unresectable HCC: The LEGACY Study[J]. Hepatology, 2021.
[16] MURTHY R, NUNEZ R, SZKLARUK J, et al. Yttrium-90 microsphere therapy for hepatic malignancy: devices, indications, technical considerations,potential complications[J]. Radiographics, 2005, 25 Suppl 1: S41-S55.
[17] LEE E J, CHUNG H W, JO J H, et al.Radioembolization for the Treatment of Primary and Metastatic Liver Cancers[J]. Nucl Med Mol Imaging, 2019, 53(6): 367-373.
[18] MOHAMED M, KATZ A W, TEJANI M A, et al.Comparison of outcomes between SBRT, yttrium-90 radioembolization, transarterial chemoembolization, and radiofrequency ablation as bridge to transplant for hepatocellular carcinoma[J]. Adv Radiat Oncol, 2016, 1(1): 35-42.
[19] SHETH R A, PATEL M S, KOOTTAPPILLIL B, et al.Role of Locoregional Therapy and Predictors for Dropout in Patients with Hepatocellular Carcinoma Listed for Liver Transplantation[J]. J Vasc Interv Radiol, 2015, 26(12): 1761-1768.
[20] RIAZ A, GATES V L, ATASSI B, et al.Radiation segmentectomy: a novel approach to increase safety and efficacy of radioembolization[J]. Int J Radiat Oncol Biol Phys, 2011, 79(1): 163-171.
[21] VOUCHE M, HABIB A, WARD TJ, et al.Unresectable solitary hepatocellular carcinoma not amenable to radiofrequency ablation: multicenter radiology-pathology correlation and survival of radiation segmentectomy[J]. Hepatology, 2014, 60(1): 192-201.
[22] PADIA S A, JOHNSON G E, HORTON K J, et al.Segmental Yttrium-90 Radioembolization versus Segmental Chemoembolization for Localized Hepatocellular Carcinoma: Results of a Single-Center, Retrospective, Propensity Score-Matched Study[J]. J Vasc Interv Radiol, 2017, 28(6): 777-785 e771.
[23] SHINKAWA H, TAKEMURA S, TANAKA S, et al.Portal Vein Embolization: History and Current Indications[J]. Visc Med, 2017, 33(6): 414-417.
[24] GABA R C, LEWANDOWSKI R J, KULIK L M, et al.Radiation lobectomy: preliminary findings of hepatic volumetric response to lobar yttrium-90 radioembolization[J]. Ann Surg Oncol, 2009, 16(6): 1587-1596.
[25] OKUDA K, OHNISHI K, KIMURA K, et al.Incidence of portal vein thrombosis in liver cirrhosis. An angiographic study in 708 patients[J]. Gastroenterology, 1985, 89(2): 279-286.
[26] KULIK L M, CARR B I, MULCAHY M F, et al.Safety and efficacy of ⁹⁰Y radiotherapy for hepatocellular carcinoma with and without portal vein thrombosis[J]. Hepatology, 2008, 47(1): 71-81.
[27] MEMON K, KULIK L, LEWANDOWSKI R J, et al.Radioembolization for hepatocellular carcinoma with portal vein thrombosis: impact of liver function on systemic treatment options at disease progression[J]. J Hepatol, 2013, 58(1): 73-80.
[28] MAZZAFERRO V, SPOSITO C, BHOORI S, et al.Yttrium-90 radioembolization for intermediate-advanced hepatocellular carcinoma: a phase 2 study[J]. Hepatology, 2013, 57(5): 1826-1837.
[29] WANG D S, LOUIE J D, SZE D Y.Evidence-Based Integration of Yttrium-90 Radioembolization in the Contemporary Management of Hepatic Metastases from Colorectal Cancer[J]. Tech Vasc Interv Radiol, 2019, 22(2): 74-80.
[30] RAVAL M, BANDE D, PILLAI AK, et al.Yttrium-90 radioembolization of hepatic metastases from colorectal cancer[J]. Front Oncol, 2014, 4: 120.
[31] JEYARAJAH D R, DOYLE M B M, ESPAT N J, et al. Role of yttrium-90 selective internal radiation therapy in the treatment of liver-dominant metastatic colorectal cancer: an evidence-based expert consensus algorithm[J]. J Gastrointest Oncol, 2020, 11(2): 443-460.
[32] MULCAHY M F, MAHVASH A, PRACHT M, et al.Radioembolization With Chemotherapy for Colorectal Liver Metastases: A Randomized, Open-Label, International, Multicenter, Phase Ⅲ Trial[J]. J Clin Oncol, 2021: JCO2101839.
[33] SALEM R, GABR A, RIAZ A, et al.Institutional decision to adopt Y90 as primary treatment for hepatocellular carcinoma informed by a 1,000-patient 15-year experience[J]. Hepatology, 2018, 68(4): 1429-1440.
[34] CHAN K T, ALESSIO A M, JOHNSON G E, et al.Prospective Trial Using Internal Pair-Production Positron Emission Tomography to Establish the Yttrium-90 Radioembolization Dose Required for Response of Hepatocellular Carcinoma[J]. Int J Radiat Oncol Biol Phys, 2018, 101(2): 358-365.
[35] GARIN E, TSELIKAS L, GUIU B, et al.Personalised versus standard dosimetry approach of selective internal radiation therapy in patients with locally advanced hepatocellular carcinoma (DOSISPHERE-01): a randomised, multicentre, open-label phase 2 trial[J]. Lancet Gastroenterol Hepatol, 2021, 6(1): 17-29.
[36] VOGEL A, MARTINELLI E, ESMO GUIDELINES COMMITTEE, et al.Updated treatment recommendations for hepatocellular carcinoma (HCC) from the ESMO Clinical Practice Guidelines[J]. Ann Oncol, 2021, 32(6): 801-805.
[37] TURGEON G A, WEICKHARDT A, AZAD A A, et al.Radiotherapy and immunotherapy: a synergistic effect in cancer care[J]. Med J Aust, 2019, 210(1): 47-53.
[38] MONDINI M, LEVY A, MEZIANI L, et al.Radiotherapy-immunotherapy combinations-perspectives and challenges[J]. Mol Oncol, 2020, 14(7): 1529-1537.