Radioembolization with Yttrium-90 Microspheres (SIRT) in Pancreatic Cancer Patients with Liver Metastases: Efficacy, Safety and Prognostic FactorsMichl M. · Haug A.R. · Jakobs T.F. · Paprottka P. · Hoffmann R.-T. · Bartenstein P. · Boeck S. · Haas M. · Laubender R.P. · Heinemann V.
Objective: To analyze the clinical efficacy of 90Y radioembolization in liver metastases from pancreatic cancer, to describe treatment toxicities and to identify biomarkers as predictors of outcome. Methods: Data from 19 pancreatic cancer patients (9 females/10 males) who had received 90Y radioembolization for metastatic liver disease between 06/2004 and 01/2011 were analyzed retrospectively. Results: The median age at 90Y radioembolization was 63 years (range 43-77). In 16 patients, previous palliative gemcitabine-based chemotherapy was given for metastatic disease. Objective response in the liver after 90Y radioembolization was 47%. Median local progression-free survival in the liver was 3.4 months (range 0.9-45.0). Median overall survival (OS) was 9.0 months (range 0.9-53.0) and 1-year survival was 24%. Cox regression models for baseline biomarkers at 90Y radioembolization revealed correlations of increased carbohydrate antigen 19-9 (p = 0.02) and C-reactive protein (p = 0.03) with shorter OS. Short-term adverse events (nausea, vomiting, fatigue, fever and abdominal pain) did not exceed grade 3. As long-term adverse events, liver abscesses, gastroduodenal ulceration, cholestasis and cholangitis, ascites and spleen infarction were observed. Conclusion:90Y radioembolization is able to induce an encouraging local response rate of liver metastases of pancreatic cancer patients. Most short-term toxicities are manageable; however, patients should be followed up carefully for severe long-term toxicities. © 2013 S. Karger AG, Basel
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