Transarterial radioembolization to treat primary or secondary liver cancer, D Schnappauf

International Cancer Imaging Society October 2017.

https://www.icimagingsociety.org.uk/

D. Schnapauff

Charité, Universitätsmedizin Berlin, Departement of Radiology, Augustenburger Platz 1, 13353 Berlin, Germany

Hepatic radioembolization is a relatively new and developing modality for treating non-resectable primary or secondary liver tumours. Yttrium-90 coated microspheres are transarterially injected via a microcatheter into the hepatic artery. Preferential uptake into liver tumours is achieved by the predominant hepatic arterial supply whereas healthy liver tissue is predominantly perfused by the portal vein.

Radioembolization is currently indicated in patients with advanced tumour burden in a palliative situation with hepatocellular carcinoma, colorectal or neuroendocrine liver metastasis. Patients should have liver-dominant tumour burden and the liver must be estimated the life expectancy limiting organ.

First randomised trials like the SIRFLOX-trial investigating Y-90 microspheres in patients with previously untreated metastatic colorectal cancer did not an improvement of overall survival but a significantly delayed disease progression in the liver. Data of the SORAMIC-trial evaluating sorafenib ± Y-90 microspheres are not yet published, safety data published showed that the combination appears to be as well tolerated as sorafenib alone.

The presentation will discuss technical requirements for radioembolization and its current clinical role in multimodal treatment of cancer.