title: Regression of liver metastases following treatment with yttrium-90 microspheres.
abstract: Selective internal radiation (SIR) therapy is a technique developed by our group for concentration of Yttrium-90 microspheres into liver metastases. The technique involves laparotomy, insertion of the catheter into the hepatic artery, redistribution of liver blood flow with vaso-active agents and incremental embolization of Yttrium-90 containing microspheres (SIR spheres) into the liver. Twenty-nine patients with non-resectable liver metastases from primary adenocarcinoma of the large bowel were treated by this technique and followed for a minimum of three months to assess evidence of tumour regression. Response to treatment was measured by serial estimations of carcino-embryonic antigen (CEA) and tumour volumes measured from serial computerized tomography (CT) scanning of the liver. There was a fall in the serum CEA level in all 26 patients in whom the serial estimations of CEA were performed following SIR therapy. The overall mean fall in CEA was 70% of pre-treatment levels with 88% of patients (23 of 26) experiencing more than a 50% fall in pre-treatment CEA levels. In 18 of 22 evaluable patients CT measured tumour volumes decreased following SIR therapy. In 48% of patients (10 of 22 patients) the decrease in tumour volume was more than 50%. SIR therapy results in a high rate of tumour regression in patients with liver metastases secondary to large bowel cancer.
authors.affiliation: University Department of Surgery, Royal Perth Hospital, Western Australia.
authors.forename: B N
authors.initials: BN
authors.lastname: Gray
authors.forename: J E
authors.initials: JE
authors.lastname: Anderson
authors.forename: M A
authors.initials: MA
authors.lastname: Burton
authors.forename: G
authors.initials: G
authors.lastname: van Hazel
authors.forename: J
authors.initials: J
authors.lastname: Codde
authors.forename: C
authors.initials: C
authors.lastname: Morgan
authors.forename: P
authors.initials: P
authors.lastname: Klemp
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000532:radiotherapy* / Q000556:secondary / Q000628:therapy; D000328:Adult; D000368:Aged; D002272:Carcinoembryonic Antigen / Q000032:analysis; D010478:Chemotherapy, Cancer, Regional Perfusion; D003110:Colonic Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000532:radiotherapy* / Q000556:secondary / Q000628:therapy; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011878:Radiotherapy / Q000379:methods; D012074:Remission Induction / Q000379:methods; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D002272:Carcinoembryonic Antigen; D015021:Yttrium Radioisotopes; D005472:Fluorouracil