Gastroduodenal injury after radioembolization of hepatic tumors.
BACKGROUND
Radioembolization is a new tool for the treatment of hepatic tumors that consists in the injection of biocompatible microspheres carrying radioisotopes into the hepatic artery or its branches.


METHODS
We have performed radioembolization in 78 patients with hepatic tumors using resin-based microspheres loaded with yttrium-90. All patients were previously evaluated to minimize the risk of hazardous irradiation to nontarget organs and to obtain the data needed for dose calculation.


RESULTS
We report a complication found in three cases (3.8%) that consists of abdominal pain resulting from gastroduodenal lesions and that had a chronic, insidious course. Microscopically, microspheres were detected in the specimens obtained from all affected gastric areas. Since these gastroduodenal lesions do not appear when nonradiating microspheres are injected in animals, lesions are likely to be due to radiation and not to an ischemic effect of vascular occlusion by spheres.


CONCLUSIONS
We believe that a pretreatment evaluation that includes a more thorough scrutiny of the hepatic vascularization in search of small collaterals connecting to the gastroduodenal tract can help prevent this awkward complication.
Carretero
Cristina
C
Department of Gastroenterology, Liver Unit, University Clinic of Navarra, Navarra, Spain.
Munoz-Navas
Miguel
M
Betes
Maite
M
Angos
Ramon
R
Subtil
Jose C
JC
Fernandez-Urien
Ignacio
I
De la Riva
Susana
S
Sola
Josu
J
Bilbao
Jose I
JI
de Luis
Esther
E
Sangro
Bruno
B
D000818:Animals; D002291:Carcinoma, Papillary / Q000532:radiotherapy; D002292:Carcinoma, Renal Cell / Q000532:radiotherapy; D003097:Collateral Circulation; D004386:Duodenum / Q000098:blood supply / Q000528:radiation effects*; D004621:Embolization, Therapeutic; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000532:radiotherapy; D012189:Retrospective Studies; D013270:Stomach / Q000098:blood supply / Q000528:radiation effects*; D015021:Yttrium Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects*
D015021:Yttrium Radioisotopes