title: Intra-arterial radioembolization of breast cancer liver metastases: a structured review.
abstract: Radioembolization using yttrium-90 microspheres (⁹⁰Y-RE) is an emerging treatment option for breast cancer liver metastases (BCLM) patients if other locoregional and systemic treatment options fail. The purpose of this study was to provide a systematic overview of the current literature concerning ⁹⁰Y-RE for BCLM patients. A systematic search for relevant articles was performed in MEDLINE, EMBASE, and The Cochrane Library (January 2012) by combining an extensive list of synonyms for the determinants 'radioembolization', 'yttrium-90' and 'microsphere' with synonyms for the domain 'liver'. Data on tumor response, survival and toxicity were extracted and collected from all relevant articles. The search yielded 4078 studies, of which six were finally included for analysis, concerning a total of 198 patients. Tumor response was scored in five studies using either RECIST (n=3) or WHO criteria (n=2). Overall disease control rates (complete response, partial response and stable disease) at 2-4 months post treatment ranged from 78% to 96%. Median survival, available in four studies, ranged from 10.8 to 20.9 months. In total, gastric ulceration was reported in ten patients (5%) and treatment related mortality in three patients (2%). The results from the analyzed studies consistently show that ⁹⁰Y-RE is a safe and effective treatment option for BCLM patients. Comparative studies, especially combining ⁹⁰Y-RE with systemic therapy are strongly encouraged.
authors.affiliation: Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
authors.forename: Maarten L J
authors.initials: ML
authors.lastname: Smits
authors.forename: Jip F
authors.initials: JF
authors.lastname: Prince
authors.forename: Charlotte E N M
authors.initials: CE
authors.lastname: Rosenbaum
authors.forename: Andor F
authors.initials: AF
authors.lastname: van den Hoven
authors.forename: J Frank W
authors.initials: JF
authors.lastname: Nijsen
authors.forename: Bernard A
authors.initials: BA
authors.lastname: Zonnenberg
authors.forename: Beatrijs A
authors.initials: BA
authors.lastname: Seinstra
authors.forename: Marnix G E H
authors.initials: MG
authors.lastname: Lam
authors.forename: Maurice A A J
authors.initials: MA
authors.lastname: van den Bosch
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000009:adverse effects; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D008863:Microspheres; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016879:Salvage Therapy / Q000009:adverse effects; D013276:Stomach Ulcer / Q000209:etiology; D016019:Survival Analysis; D047368:Tumor Burden / Q000528:radiation effects; D015021:Yttrium Radioisotopes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes