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90Y Resin Microspheres Radioembolization for Colon Cancer Liver Metastases Using Full-Strength Contrast Material

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Abstract

Objectives

To assess safety and efficacy of 90Y resin microspheres administration using undiluted non-ionic contrast material (UDCM) {100% Omnipaque-300 (Iohexol)} in both the “B” and “D” lines.

Materials and methods

We reviewed all colorectal cancer liver metastases patients treated with 90Y resin microspheres radioembolization (RAE) from 2009 to 2017. As of April 2013, two experienced operators started using UDCM (study group) instead of standard sandwich infusion (control group). Occurrence of myelosuppression (leukopenia, neutropenia, erythrocytopenia or/and thrombocytopenia), stasis, nontarget delivery (NTD), median fluoroscopy radiation dose (FRD), median infusion time (IT), liver progression-free (LPFS) and overall survivals (OS) was evaluated. Complications within 6 months post-RAE were reported according to CTCAE v3.0 criteria.

Results

Study and control groups comprised 23(28%) and 58(72%) patients, respectively. Median follow-up was 9.1 months. There was no statistically significant difference in myelosuppression incidence within 6 months post-RAE between groups. Median FRD and IT for study and control groups were 44.6 vs. 97.35 Gy/cm2 (p = 0.048) and 31 vs. 39 min (p = 0.006), respectively. A 38% lower stasis incidence in study group was not significant (p = 0.34). NTD occurred in 1/27(4%) study vs. 5/73(7%) control group procedures (p = 1). Grade 1–2 and grade 3–4 toxicities between study and control group patients were 36%(8/22) vs. 45%(26/58), p = 0.61 and 9%(2/22) vs. 16%(9/58), p = 0.72, respectively. There was no difference in LPFS and OS between groups.

Conclusion

Administration of 90Y resin microspheres using UDCM in both lines is safe and effective, resulting in lower fluoroscopy radiation dose and shorter infusion time, without evidence of myelosuppression or increased stasis incidence.

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Funding

The research funded by the Memorial Sloan Kettering Cancer Center Support Grant/Core Grant (P30 CA008748).

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Authors and Affiliations

  1. Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    I. Kurilova, F. E. Boas, E. N. Petre, H. Yarmohammadi, E. Ziv, A. R. Deipolyi, L. A. Brody & Constantinos T. Sofocleous

  2. Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands

    I. Kurilova & R. G. H. Beets-Tan

  3. GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands

    I. Kurilova & R. G. H. Beets-Tan

  4. Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA

    G. A. Ulaner

  5. Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, USA

    M. Gonen

Authors
  1. I. Kurilova
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  2. R. G. H. Beets-Tan
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  3. G. A. Ulaner
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  4. F. E. Boas
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  5. E. N. Petre
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  6. H. Yarmohammadi
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  7. E. Ziv
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  8. A. R. Deipolyi
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  9. L. A. Brody
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  10. M. Gonen
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  11. Constantinos T. Sofocleous
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Corresponding author

Correspondence to Constantinos T. Sofocleous.

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Conflict of interest

C. T. Sofocleous has received research support in the past and was a consultant for Sirtex Medical. Other authors have no conflicts of interest.

Ethical Approval

IRB waiver of approval was obtained for this retrospective cohort study. The database was HIPAA registered and compliant.

Informed Consent

The patients signed informed consent for the procedure.

Clinical Relevance Statement

90Y resin microsphere administration using undiluted non-ionic contrast material was safe and effective, providing continuous real-time infusion monitoring as well as decreasing infusion time and fluoroscopy radiation dose.

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Kurilova, I., Beets-Tan, R.G.H., Ulaner, G.A. et al. 90Y Resin Microspheres Radioembolization for Colon Cancer Liver Metastases Using Full-Strength Contrast Material. Cardiovasc Intervent Radiol 41, 1419–1427 (2018). https://doi.org/10.1007/s00270-018-1985-1

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  • DOI: https://doi.org/10.1007/s00270-018-1985-1

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