90Y radioembolization of metastatic breast cancer to the liver: toxicity, imaging response, survival.
OBJECTIVE
To present data from patients with breast cancer liver metastases who underwent radioembolization with yttrium (90Y) microspheres.


METHODS
Using standard 90Y lobar treatment protocol, 27 female patients with progressing liver metastases on standard of care polychemotherapy were treated under an open-label phase 2 protocol. After treatment, we assessed (a) tumor response using computed tomography and/or positron emission tomography, (b) biochemical toxicity, and (c) survival.


RESULTS
The mean age of the patients was 52. Seventeen (63%) patients received 20 left lobe treatments (median radiation dose, 123 Gy; mean, 119 Gy), and 20 (74%) patients received 22 right lobe treatments (median radiation dose, 121 Gy; mean, 109 Gy) to the treatment site. No significant dose-difference was noted between the two lobes (P=.69). Tumor response on 90-day follow-up computed tomography showed (a) complete and partial response in nine (39.1%) patients, (b) stable disease in 12 (52.1%) patients, and (c) progressive disease in 2 (8.8%) patients. Positive tumor response on positron emission tomography was noted in 17 (63%) patients. Three of 27 (11%) patients (Eastern Cooperation Oncology Group 1, 2, or 3) showed bilirubin toxicity of grade 3, all of which were attributed to disease progression. Median survival for Eastern Cooperation Oncology Group 0 versus 1, 2, or 3 patients was 6.8 months and 2.6 months, respectively (P=.24) and for patients with tumor burden<25% versus >25% was 9.4 and 2.0 months, respectively (P=.46).


CONCLUSIONS
Radioembolization with 90Y brachytherapy device may be a viable therapeutic option for the treatment of breast cancer liver metastases in patients who have progressed or failed on standard of care polychemotherapy.
Bangash
Affaan K
AK
Department of Radiology, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 800, Chicago, IL 60611, USA.
Atassi
Bassel
B
Kaklamani
Virginia
V
Rhee
Thomas K
TK
Yu
Maurice
M
Lewandowski
Robert J
RJ
Sato
Kent T
KT
Ryu
Robert K
RK
Gates
Vanessa L
VL
Newman
Steven
S
Mandal
Robert
R
Gradishar
William
W
Omary
Reed A
RA
Salem
Riad
R
D001918:Brachytherapy; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D008863:Microspheres; D008875:Middle Aged; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage*
D015021:Yttrium Radioisotopes