TY - JOUR
T1 - Safety of yttrium-90 microsphere radioembolization in patients with biliary obstruction
AU - Gaba, Ron C.
AU - Riaz, Ahsun
AU - Lewandowski, Robert J.
AU - Ibrahim, Saad M.
AU - Ryu, Robert K.
AU - Sato, Kent T.
AU - Omary, Reed A.
AU - Salem, Riad
PY - 2010
Y1 - 2010
N2 - PURPOSE: There are few data on radioembolization in the setting of biliary obstruction. The present study was performed to assess the safety of yttrium-90 (90Y) radioembolization in the setting of tumor-related biliary obstruction and total bilirubin levels of 2 mg/dL or lower. MATERIALS AND METHODS: Twelve patients with liver tumors underwent 19 treatment sessions with 90Y to the obstructed liver lobe or segment. Initial bilirubin level was 2 mg/dL or lower in all cases. Measured outcomes included pre-and posttreatment white blood cell (WBC) count, total bilirubin level, and alkaline phosphatase (ALP) level. Bilirubin toxicities and biliary complications were assessed according to Common Toxicity Criteria, version 3.0. RESULTS: Lobar or segmental 90Y was successful in all cases. Pre-and posttreatment median WBC counts (5.3 vs 5.3; P =.490), bilirubin levels (1.0 vs 1.1; P =.460), and ALP levels (195 vs 146; P =.712) showed no differences. One case of grade 3 bilirubin toxicity was noted in a patient with liver hilar nodal progression and subsequent biliary obstruction requiring external drainage. Complete resolution of biliary obstruction was seen after 90Y treatment in one case of metastatic colorectal carcinoma at 1 month follow-up. No biliary complications (infection, sepsis, biliary necrosis, biloma formation, abscess development, or biliary stricture) were encountered in this cohort during an overall median follow-up time of 22.9 months. CONCLUSIONS: The use of 90Y glass microspheres demonstrated a good safety profile in the setting of tumor-related biliary obstruction in patients with normal or near-normal bilirubin levels in this series, without evidence of therapy-related progressive leukocytosis, bilirubin increase, or infectious or biliary complications after treatment.
AB - PURPOSE: There are few data on radioembolization in the setting of biliary obstruction. The present study was performed to assess the safety of yttrium-90 (90Y) radioembolization in the setting of tumor-related biliary obstruction and total bilirubin levels of 2 mg/dL or lower. MATERIALS AND METHODS: Twelve patients with liver tumors underwent 19 treatment sessions with 90Y to the obstructed liver lobe or segment. Initial bilirubin level was 2 mg/dL or lower in all cases. Measured outcomes included pre-and posttreatment white blood cell (WBC) count, total bilirubin level, and alkaline phosphatase (ALP) level. Bilirubin toxicities and biliary complications were assessed according to Common Toxicity Criteria, version 3.0. RESULTS: Lobar or segmental 90Y was successful in all cases. Pre-and posttreatment median WBC counts (5.3 vs 5.3; P =.490), bilirubin levels (1.0 vs 1.1; P =.460), and ALP levels (195 vs 146; P =.712) showed no differences. One case of grade 3 bilirubin toxicity was noted in a patient with liver hilar nodal progression and subsequent biliary obstruction requiring external drainage. Complete resolution of biliary obstruction was seen after 90Y treatment in one case of metastatic colorectal carcinoma at 1 month follow-up. No biliary complications (infection, sepsis, biliary necrosis, biloma formation, abscess development, or biliary stricture) were encountered in this cohort during an overall median follow-up time of 22.9 months. CONCLUSIONS: The use of 90Y glass microspheres demonstrated a good safety profile in the setting of tumor-related biliary obstruction in patients with normal or near-normal bilirubin levels in this series, without evidence of therapy-related progressive leukocytosis, bilirubin increase, or infectious or biliary complications after treatment.
KW - ALP
KW - HCC
KW - WBC
KW - alkaline phosphatase
KW - hepatocellular carcinoma
KW - white blood cell
UR - http://www.scopus.com/inward/record.url?scp=77955714161&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955714161&partnerID=8YFLogxK
U2 - 10.1016/j.jvir.2010.04.013
DO - 10.1016/j.jvir.2010.04.013
M3 - Article
C2 - 20598575
AN - SCOPUS:77955714161
SN - 1051-0443
VL - 21
SP - 1213
EP - 1218
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 8
ER -