Radioembolization using Yttrium-90 microspheres in 58 patients with liver metastases from breast cancer
Menée sur 58 patientes ayant reçu une polychimiothérapie pour un cancer du sein et présentant des métastases hépatiques non résécables traitées entre 2002 et 2008 (durée médiane de suivi : 4,2 mois), cette étude rétrospective évalue, du point de vue de la survie globale, la toxicité et la réponse tumorale associée à une seule séance de radioembolisation du foie total par microsphères chargées en Yttrium 90
Purpose To evaluate clinical outcomes associated with single-session, whole-liver radioembolization with Yttrium-90 (90Y)-labeled resin microspheres in patients with nonresectable liver metastases from breast cancer that were refractory to other treatments. Methods A retrospective analysis of consecutive patients who were treated between January 2002 and October 2008 was performed. Fifty-eight patients with unresectable liver metastases from breast cancer who had a good performance status and a low burden of extrahepatic disease were eligible for RE. Patients had undergone polychemotherapy regimens including at least anthracyclines and taxanes, hormonal therapy, and trastuzumab were applicable. Results A median activity of 1.93 GBq of 90Y was delivered. Follow-up at a median of 4.2 months demonstrated complete response, partial response, stable disease, and progressive disease in 5, 52, 31, and 12 % of patients, respectively. With respect to tumor diameters, imaging revealed a maximum and minimum response of −57.6 to +25.8 %, respectively. The median overall survival was 12.3 months. The median survival of responders and nonresponders was 20.9 and 6.3 months, respectively, and the median survival of patients with and patients without extrahepatic disease was 8.3 and 16.2 months, respectively. Clinically significant toxicities with the appearance of increasing transaminase level, increasing bilirubin level, nausea and vomiting, gastric ulcers, and ascites. Conclusions Single-session, whole-liver 90Y radioembolization can be performed with an acceptable toxicity profile in patients with liver metastases from breast cancer.