title: Yttrium-90 Radioembolization of Advanced, Unresectable Breast Cancer Liver Metastases-A Single-Center Experience.
abstract: OBJECTIVE
  To determine value of transarterial radioembolization (TARE) for palliative treatment of unresectable liver-dominant breast metastases (LdBM) and to determine prognostic parameters.
  
  
  METHODS
  Records of patients undergoing TARE for progressing LdBM between June 2006 and March 2015 were retrospectively reviewed; 44 female patients (mean age 56.1 y; range, 34.9-85.3 y) underwent 69 TAREs (56 resin-based, 13 glass-based). Of 44 patients, 42 had bilobar disease. Mean administered activity was 1.35 GBq ± 0.71. Median clinical and imaging follow-up times were 121 days (range, 26-870 d; n = 42 patients) and 93 days (range, 26-2,037 d; n = 38 patients). Clinical and biochemical toxicities, imaging response (according to Response Evaluation Criteria In Solid Tumors), time to progression, and overall survival (OS) were evaluated. Data were analyzed with stratification according to clinical and procedural parameters.
  
  
  RESULTS
  Toxicities included 1 cholecystitis (grade 2) and 1 duodenal ulceration (grade 3); no grade ≥ 4 clinical toxicities were noted. Objective response rate (complete + partial response) was 28.9% (11/38); disease control rate (response + stable disease) was 71.1% (27/38). Median time to progression of treated liver lobe was 101 days (range, 30-2,037 d). During follow-up, 34/42 patients died (median OS after first TARE: 184 d [range 29-2,331 d]). On multivariate analysis, baseline Eastern Cooperative Oncology Group (ECOG) status of 0 (P < .0001, hazard ratio [HR] = 0.146) and low baseline γ-glutamyltransferase (GGT) levels (P = .0146, HR = 0.999) were predictors of longer OS.
  
  
  CONCLUSIONS
  TARE can successfully delay progression of therapy-refractory LdBM with low complication rate. Nonelevated baseline ECOG status and low GGT levels were identified as prognostic factors.
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany. Electronic address: claus.christian.pieper@ukb.uni-bonn.de.
authors.forename: Claus Christian
authors.initials: CC
authors.lastname: Pieper
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Carsten
authors.initials: C
authors.lastname: Meyer
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Kai E
authors.initials: KE
authors.lastname: Wilhelm
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Block
authors.affiliation: Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Nadal
authors.affiliation: Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Hojjat
authors.initials: H
authors.lastname: Ahmadzadehfar
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Winfried Albert
authors.initials: WA
authors.lastname: Willinek
authors.affiliation: Department of Radiology, University of Bonn, Sigmund-Freud-Strasse 25, Bonn 53105, Germany.
authors.forename: Hans Heinz
authors.initials: HH
authors.lastname: Schild
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology*; D018450:Disease Progression; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D008875:Middle Aged; D015999:Multivariate Analysis; D010166:Palliative Care; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals / Q000008:administration & dosage* / Q000009:adverse effects; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes