A phase I dose escalation trial of yttrium-90 microspheres in the treatment of primary hepatocellular carcinoma.
METHODS
Ten patients with primary hepatocellular carcinoma were treated with intraarterial instillation of yttrium-90 (Y-90) microspheres, including eight men and two women (median age, 52 years; range, 29-69 years). Four patients were treated at a targeted hepatic dose of 50 Gy, two at 75 Gy, and four at 100 Gy.


RESULTS
In 8 of the 10 patients, there was a significant concentration of Y-90 in localized tumor masses with tumor-to-liver perfusion ratios from 1.0:1-10.0:1. No patient had a complete or partial response, but 10 patients had stable disease (median duration, 10 weeks; range, 5-64 weeks). The median survival was 18 weeks (range, 2-150 weeks), and three patients lived longer than 1 year. Significant bone marrow or hepatic toxicity was not seen. One patient had a radiation-induced duodenal ulcer that required surgical management.


CONCLUSIONS
Intraarterial instillation of Y-90 microspheres appears to be safe and deserves additional evaluation to determine whether there is meaningful activity in patients with primary hepatocellular carcinoma.
Shepherd
F A
FA
Department of Medicine, Toronto Hospital, Ontario, Canada.
Rotstein
L E
LE
Houle
S
S
Yip
T C
TC
Paul
K
K
Sniderman
K W
KW
D000328:Adult; D000368:Aged; D001918:Brachytherapy; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007269:Injections, Intra-Arterial; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012074:Remission Induction; D015021:Yttrium Radioisotopes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D015021:Yttrium Radioisotopes