title: Management and prevention of adverse effects related to treatment of liver tumours with 90Y microspheres.
abstract: OBJECTIVE
  Selective internal radiation therapy with 90Y microspheres (SIR spheres) is increasingly used in the treatment of extensive liver tumours. Careful selection and preparation of patients are necessary to avoid possible adverse effects. We aimed to evaluate the incidence and severity of adverse effects resulting from the administration of SIR spheres during therapy.
  
  
  METHODS
  Between June 2004 and August 2006, 21 patients (11 women and 10 men; age range 40-75 years; mean, 58 years) with a wide range of extensive liver tumours were treated with SIR spheres. The mean administered dose was 1.87 GBq (range 1.2-2.5 GBq). During the follow-up period of 26 months, all adverse effects were monitored and classified according to the National Cancer Institute criteria.
  
  
  RESULTS
  Four patients had adverse effects: one case of cholecystitis followed by fibrosis and portal hypertension, one case of peptic ulceration and two cases of radiation hepatitis. All cases responded to appropriate therapy.
  
  
  CONCLUSIONS
  Proper selection of patients and accurate interpretation of pre-treatment investigations are vital for minimizing adverse effects following therapy with SIR spheres. In our experience, all adverse effects were moderate with no life-threatening consequences.
authors.affiliation: Department of Nuclear Medicine, S. Maria della Misericordia Hospital, Rovigo, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Szyszko
authors.forename: Adil
authors.initials: A
authors.lastname: Al-Nahhas
authors.forename: Paul
authors.initials: P
authors.lastname: Tait
authors.forename: D
authors.initials: D
authors.lastname: Rubello
authors.forename: Ruben
authors.initials: R
authors.lastname: Canelo
authors.forename: Nagy
authors.initials: N
authors.lastname: Habib
authors.forename: Long
authors.initials: L
authors.lastname: Jiao
authors.forename: Harpreet
authors.initials: H
authors.lastname: Wasan
authors.forename: D
authors.initials: D
authors.lastname: Bansi
authors.forename: A
authors.initials: A
authors.lastname: Thillainayagam
authors.forename: K
authors.initials: K
authors.lastname: Nijran
authors.forename: G
authors.initials: G
authors.lastname: Stamp
authors.forename: E
authors.initials: E
authors.lastname: O'Rourke
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000532:radiotherapy*; D002764:Cholecystitis / Q000209:etiology; D005260:Female; D005355:Fibrosis / Q000209:etiology; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D008113:Liver Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D010437:Peptic Ulcer / Q000209:etiology; D014057:Tomography, X-Ray Computed; D015021:Yttrium Radioisotopes / Q000009:adverse effects* / Q000627:therapeutic use*
chemical_list: D015021:Yttrium Radioisotopes