title: Y-90 Radiomicrosphere Therapy for Colorectal Cancer Liver Metastases.
abstract: At present, the systemic treatment of unresectable colorectal cancer liver metastases involves oxaliplatin and irinotecan-based chemotherapy regimens combined with targeted therapies such as bevacizumab (Avastin) and cetuximab (Erbitux). Radiation therapy, traditionally, is not considered a viable treatment modality owing to its unacceptably high hepatic toxicity, and still steering traditional wisdom or dogma that chemoradiation cannot be an oncological strategy for a stage IV disease. Selective internal radiation treatment with yttrium-90 (Y-90) radiomicrospheres has emerged as an effective liver-directed therapy with a favorable therapeutic ratio. Since its early clinical trials, it has demonstrated improved response rates when used in conjunction with systemic or regional chemotherapy. This article reviews the clinical role for Y-90 radiomicrosphere therapy in the contemporary management of colorectal cancer liver metastases. All the structured clinical trials, to date, are summarized, including those that studied the value of combined Y-90 radiomicrosphere therapy and current chemotherapy protocols.
authors.affiliation: Department of Surgery, Herbert Wertheim College of Medicine, Florida International University, Miami, FL. Electronic address: sgulec@fiu.edu.
authors.forename: Seza A
authors.initials: SA
authors.lastname: Gulec
mesh_terms: D000818:Animals; D015179:Colorectal Neoplasms / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000532:radiotherapy* / Q000556:secondary*; D008863:Microspheres; D015021:Yttrium Radioisotopes / Q000737:chemistry* / Q000627:therapeutic use*
chemical_list: D015021:Yttrium Radioisotopes