Transarterial Yttrium-90 Radioembolization Treatment of Patients with Liver-Dominant Metastatic Renal Cell Carcinoma

J Vasc Interv Radiol. 2017 Feb;28(2):254-259. doi: 10.1016/j.jvir.2016.09.025. Epub 2016 Dec 7.

Abstract

Purpose: To evaluate safety and efficacy of transarterial hepatic radioembolization treatment of patients with liver-dominant metastatic renal cell carcinoma (RCC).

Materials and methods: From July 2010 to December 2014, 18 patients with liver-dominant metastatic RCC were treated with yttrium-90 glass microsphere radioembolization. Retrospective review of medical records and imaging studies was performed to evaluate toxicities, treatment response, and overall survival. The median follow-up period from radioembolization treatment was 17.8 months (range, 3-54.4 months).

Results: Median overall survival from RCC diagnosis was 64 months (95% confidence interval [CI], 0-144.1 months), from diagnosis of liver metastasis was 29 months (95% CI, 7.2-50.8 months), and from radioembolization treatment was 22.8 months (95% CI, 13.2-32.3 months). After treatment, 10 patients reported grade 1 clinical toxicities, and 8 patients had grade 1 or 2 biochemical toxicities. The best radiographic responses of 17 patients who underwent contrast-enhanced cross-sectional imaging showed complete response in 16 patients and partial response in 1 patient evaluated by modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. The last available imaging of these 17 patients demonstrated complete response in 14 patients, partial response in 1 patient, and progression of disease in 2 patients. Images of a patient who underwent noncontrast CT showed stable disease as best response and stable disease on the last available imaging evaluated by RECIST.

Conclusions: Radioembolization is safe and effective and led to improved hepatic disease control and overall survival in patients with liver-dominant metastatic RCC.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Renal Cell / diagnostic imaging
  • Carcinoma, Renal Cell / mortality
  • Carcinoma, Renal Cell / secondary*
  • Carcinoma, Renal Cell / therapy*
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Embolization, Therapeutic / mortality
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Kidney Neoplasms / mortality
  • Kidney Neoplasms / pathology*
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Radiopharmaceuticals / administration & dosage*
  • Radiopharmaceuticals / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Yttrium Radioisotopes / administration & dosage*
  • Yttrium Radioisotopes / adverse effects

Substances

  • Radiopharmaceuticals
  • Yttrium Radioisotopes