Radioembolization Outside of the Liver

Abstract

Transarterial radioembolization (TARE) with yttrium-90 microspheres has emerged as an effective therapy for the treatment of both primary and metastatic hepatic lesions. It has been studied most extensively in hepatocellular carcinoma (HCC) and metastatic colorectal lesions (mCRC). The clinical success of TARE in HCC and mCRC has led to further investigation of expanding treatment to other malignancies involving the liver such as neuroendocrine carcinoma, uveal melanoma, and breast carcinoma, among others. Furthermore, interest in applications of TARE outside of the liver is emerging and small initial studies have been performed primarily in animal models to assess the effects of TARE on other organs such as the brain, stomach, spleen, kidney, and lungs. This review summarizes existing literature on the use of TARE outside of the liver.

Keywords

radioembolization - renal cell carcinoma - pulmonary metastatic disease - non-small cell lung cancer - spleen - stomach - glioblastoma

Publikationsverlauf

Eingereicht: 30. November 2020

Angenommen: 10. Februar 2021

Artikel online veröffentlicht:
15. April 2021

• References

• 1 Sato KT, Lewandowski RJ, Mulcahy MF. et al. Unresectable chemorefractory liver metastases: radioembolization with 90Y microspheres--safety, efficacy, and survival. Radiology 2008; 247 (02) 507-515
• 2 Correa RJM, Louie AV, Staehler M. et al. Stereotactic radiotherapy as a treatment option for renal tumors in the solitary kidney: a multicenter analysis from the IROCK. J Urol 2019; 201 (06) 1097-1104
• 3 Zimmermann A, Schubiger PA, Mettler D, Geiger L, Triller J, Rösler H. Renal pathology after arterial yttrium-90 microsphere administration in pigs. A model for superselective radioembolization therapy. Invest Radiol 1995; 30 (12) 716-723
• 4 de Silva S, Mackie S, Aslan P, Cade D, Delprado W. Histological comparison of kidney tissue following radioembolization with yttrium-90 resin microspheres and embolization with bland microspheres. Cardiovasc Intervent Radiol 2016; 39 (12) 1743-1749
• 5 Hamoui N, Gates VL, Gonzalez J, Lewandowski RJ, Salem R. Radioembolization of renal cell carcinoma using yttrium-90 microspheres. J Vasc Interv Radiol 2013; 24 (02) 298-300
• 6 Clark W, Aslan P, Patel M. et al. The RESIRT study: feasibility and dosimetry considerations of selective internal radiation therapy (SIRT) using yttrium-90 (Y-90) resin microspheres in patients with primary renal cell carcinoma (RCC). J Vasc Interv Radiol 2017; 28 (02) S164
• 7 Kahn PC, Paul RE, Rheinlander HF. Selective bronchial arteriography and intra-arterial chemotherapy in carcinoma of the lung. J Thorac Cardiovasc Surg 1965; 50 (05) 640-645
• 8 Neyazaki T, Ikeda M, Seki Y, Egawa N, Suzuki C. Bronchial artery infusion therapy for lung cancer. Cancer 1969; 24 (05) 912-922
• 9 Soderberg Jr CH, Colbert MP, Leone LA. Bronchial artery infusion therapy of lung neoplasms with nitrogen mustard. Surgery 1964; 56: 897-904
• 10 Osaki T, Hanagiri T, Nakanishi R, Yoshino I, Taga S, Yasumoto K. Bronchial arterial infusion is an effective therapeutic modality for centrally located early-stage lung cancer: results of a pilot study. Chest 1999; 115 (05) 1424-1428
• 11 Nakanishi M, Umeda Y, Demura Y. et al. Effective use of multi-arterial infusion chemotherapy for advanced non-small cell lung cancer patients: four clinical specified cases. Lung Cancer 2007; 55 (02) 241-247
• 12 Ridge CA, Solomon SB. Percutaneous ablation of colorectal lung metastases. J Gastrointest Oncol 2015; 6 (06) 685-692
• 13 Yan TD, King J, Sjarif A, Glenn D, Steinke K, Morris DL. Percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma: prognostic determinants for survival. Ann Surg Oncol 2006; 13 (11) 1529-1537
• 14 Palma DA, Olson R, Harrow S. et al. Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial. Lancet 2019; 393 (10185): 2051-2058
• 15 De Ruysscher D, Faivre-Finn C, Nestle U. et al. European Organisation for Research and Treatment of Cancer recommendations for planning and delivery of high-dose, high-precision radiotherapy for lung cancer. J Clin Oncol 2010; 28 (36) 5301-5310
• 16 Timmerman R, McGarry R, Yiannoutsos C. et al. Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol 2006; 24 (30) 4833-4839
• 17 Senthi S, Haasbeek CJA, Slotman BJ, Senan S. Outcomes of stereotactic ablative radiotherapy for central lung tumours: a systematic review. Radiother Oncol 2013; 106 (03) 276-282
• 18 Marks LB, Bentzen SM, Deasy JO. et al. Radiation dose-volume effects in the lung. Int J Radiat Oncol Biol Phys 2010; 76 (3, Suppl): S70-S76
• 19 Ricke J, Großer O, Amthauer H. Y90-radioembolization of lung metastases via the bronchial artery: a report of 2 cases. Cardiovasc Intervent Radiol 2013; 36 (06) 1664-1669
• 20 Tc99m-MAA Bronchial Artery Injection During Bronchial Embolization for Pulmonary Mass Induced Hemoptysis for Dosimetry Planning - Full Text View - ClinicalTrials.gov. Accessed November 23, 2020 at: https://clinicaltrials.gov/ct2/show/NCT04105283
• 21 Tc99m Macroaggregated Albumin Bronchial Artery Study - Full Text View - ClinicalTrials.gov. Accessed November 23, 2020 at: https://clinicaltrials.gov/ct2/show/NCT04555564
• 22 DRKS - Deutsches Register Klinischer Studien (German Clinical Trials Register). Accessed November 23, 2020 at: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00021723
• 23 Ariel IM, Padula G. Irradiation of the spleen by the intra-arterial administration of 90 yttrium microspheres in patients with malignant lymphoma. A preliminary report. Cancer 1973; 31 (01) 90-96
• 24 Muylle K, Nguyen J, de Wind A. et al. Radioembolization of the spleen: a revisited approach for the treatment of malignant lymphomatous splenomegaly. Cardiovasc Intervent Radiol 2013; 36 (04) 1155-1160
• 25 Becker CD, Rösler H, Biasiutti FD, Baer HU. Congestive hypersplenism: treatment by means of radioembolization of the spleen with Y-90. Radiology 1995; 195 (01) 183-186
• 26 Vujic I, Lauver JW. Severe complications from partial splenic embolization in patients with liver failure. Br J Radiol 1981; 54 (642) 492-495
• 27 Yttrium-90 Radioembolization for Cirrhosis-Associated Thrombocytopenia - Full Text View - ClinicalTrials.gov. Accessed January 22, 2021 at: https://clinicaltrials.gov/ct2/show/NCT03059030
• 28 Weiss CR, Gunn AJ, Kim CY, Paxton BE, Kraitchman DL, Arepally A. Bariatric embolization of the gastric arteries for the treatment of obesity. J Vasc Interv Radiol 2015; 26 (05) 613-624
• 29 Paxton BE, Kim CY, Alley CL. et al. Bariatric embolization for suppression of the hunger hormone ghrelin in a porcine model. Radiology 2013; 266 (02) 471-479
• 30 Paxton BE, Alley CL, Crow JH. et al. Histopathologic and immunohistochemical sequelae of bariatric embolization in a porcine model. J Vasc Interv Radiol 2014; 25 (03) 455-461
• 31 Pasciak A, Bourgeois A, Arepally A. et al. Bariatric radiation therapy (BaRT): proof of concept in porcine model. J Vasc Interv Radiol 2016; 27 (03) S120
• 32 Pasciak AS, Bourgeois AC, Paxton BE. et al. Bariatric radioembolization: a pilot study on technical feasibility and safety in a porcine model. J Vasc Interv Radiol 2016; 27 (10) 1509-1517
• 33 Chang CH, Horton J, Schoenfeld D. et al. Comparison of postoperative radiotherapy and combined postoperative radiotherapy and chemotherapy in the multidisciplinary management of malignant gliomas. A joint Radiation Therapy Oncology Group and Eastern Cooperative Oncology Group study. Cancer 1983; 52 (06) 997-1007
• 34 Shirazi HA, Grimm S, Raizer J, Mehta MP. Combined modality approaches in the management of adult glioblastoma. Front Oncol 2011; 1 (OCT): 36
• 35 Kleinberg L, Yoon G, Weingart JD. et al. Imaging after GliaSite brachytherapy: prognostic MRI indicators of disease control and recurrence. Int J Radiat Oncol Biol Phys 2009; 75 (05) 1385-1391
• 36 Shah JL, Li G, Shaffer JL. et al. Stereotactic radiosurgery and hypofractionated radiotherapy for glioblastoma. Neurosurgery 2018; 82 (01) 24-34
• 37 Salem R, Lewandowski RJ, Mulcahy MF. et al. Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres: a comprehensive report of long-term outcomes. Gastroenterology 2010; 138 (01) 52-64
• 38 Salem R, Mazzaferro V, Sangro B. Yttrium 90 radioembolization for the treatment of hepatocellular carcinoma: biological lessons, current challenges, and clinical perspectives. Hepatology 2013; 58 (06) 2188-2197
• 39 Rosenow UF, Findlay PA, Wright DC. The NCI-atlas of dose distributions for regular ¹²⁵I brain implants. Radiother Oncol 1987; 10 (02) 127-139
• 40 Pasciak AS, Manupipatpong S, Hui FK. et al. Correction to: yttrium-90 radioembolization as a possible new treatment for brain cancer: proof of concept and safety analysis in a canine model. EJNMMI Res 2020; 10 (01) 104