PT  - JOURNAL ARTICLE
AU  - Alina Zarva
AU  - Konrad Mohnike
AU  - Robert Damm
AU  - Juri Ruf
AU  - Ricarda Seidensticker
AU  - Gerhard Ulrich
AU  - Max Seidensticker
AU  - Maciej Pech
AU  - Jens Ricke
AU  - Holger Amthauer
TI  - Safety of Repeated Radioembolizations in Patients with Advanced Primary and Secondary Liver Tumors and Progressive Disease After First Selective Internal Radiotherapy
AID  - 10.2967/jnumed.113.127662
DP  - 2014 Mar 01
TA  - Journal of Nuclear Medicine
PG  - 360--366
VI  - 55
IP  - 3
4099  - http://jnm.snmjournals.org/content/55/3/360.short
4100  - http://jnm.snmjournals.org/content/55/3/360.full
SO  - J Nucl Med2014 Mar 01; 55
AB  - The purpose of this study was to assess the safety of repeated 90Y radioembolization with resin microspheres in patients with extensive primary and secondary liver tumors after failure of first radioembolization. Methods: Between 2007 and 2011, 21 patients (12 women, 9 men; mean age, 61.0 y) with nonresectable advanced liver tumors (breast cancer liver metastases, n = 7; colorectal liver metastases, n = 5; hepatocellular carcinoma, n = 8; cholangiocellular carcinoma, n = 1) were repeatedly treated by radioembolization. Safety was the primary endpoint. Whole-liver treatment was achieved with sequential treatment sessions in most patients, with selective embolization of the left and right liver lobes within 6 wk. Toxicity was documented prospectively and according to Common Terminology Criteria for Adverse Events 4.0 criteria based on laboratory parameters; magnetic-resonance tomography; and clinical examinations 3 d, 6 wk, and every 3 mo after selective internal radiotherapy (SIRT). Metric variables were evaluated using the Student t test. Overall survival was assessed by Kaplan–Meier statistics. Results: Patients received an average of 1.6 whole-liver treatments performed in 3.0 unilobar radioembolizations (liver lobes sequentially). The mean total activity administered was 2.57 GBq. No radioembolization-induced liver disease was observed in any of the patients. Three patients showed reversible grade III to IV toxicities according to laboratory values, which returned to pretreatment levels after 6 wk. In 1 patient, a treatment-related duodenal ulcer occurred. Median overall survival was 18 mo after first radioembolization. Conclusion: In advanced liver tumors, repeated whole-liver treatments with 90Y radioembolization can be performed with an acceptable toxicity profile.