title: Yttrium-90 radioembolization of renal cell carcinoma metastatic to the liver.
abstract: OBJECTIVE
  To investigate the safety and efficacy of yttrium-90 ((90)Y) hepatic radioembolization treatment of patients with liver-dominant metastatic renal cell carcinoma (RCC) refractory to immunotherapy and targeted therapies.
  
  
  METHODS
  Between March 2006 and December 2010, six patients with metastatic RCC underwent eight radioembolization treatments with (90)Y-labeled resin microspheres for unresectable liver-dominant metastases. All six patients had previous hepatic tumor progression despite targeted therapies or immunotherapies. All had bilobar disease and required whole-liver treatment. Clinical and biochemical toxicities were recorded, and tumor response was assessed every 2-3 months after treatment by cross-sectional imaging.
  
  
  RESULTS
  The median dose delivered was 1.89 Gbq (range 0.41-2.03 Gbq). Grade 1 and 2 toxicities were noted in all patients, primarily fatigue. Follow-up imaging was available for five patients. In follow-up periods from 2-64 months (mean 25 months), three patients showed complete responses, and 1 patient showed a partial response by standard imaging criteria, and these patients are alive at 64 months, 55 months, 17 months, and 7 months after treatment. Two patients with rapid progression of disease died within 2 months of treatment, although hepatic malignancy or failure was not the cause of death in either patient.
  
  
  CONCLUSIONS
  (90)Y radioembolization is a promising option for liver-dominant metastatic RCC with potential for providing long-term survival in patients refractory to or intolerant of targeted therapies.
authors.affiliation: Stanford University Medical Center, Stanford, CA 94305-5642, USA.
authors.forename: Mohamed H K
authors.initials: MH
authors.lastname: Abdelmaksoud
authors.forename: John D
authors.initials: JD
authors.lastname: Louie
authors.forename: Gloria L
authors.initials: GL
authors.lastname: Hwang
authors.forename: Nishita
authors.initials: N
authors.lastname: Kothary
authors.forename: David R
authors.initials: DR
authors.lastname: Minor
authors.forename: Daniel Y
authors.initials: DY
authors.lastname: Sze
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000401:mortality; D002292:Carcinoma, Renal Cell / Q000098:blood supply / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D018450:Disease Progression; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology*; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011829:Radiation Dosage; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D015021:Yttrium Radioisotopes