Complications after 90Y microsphere radioembolization for unresectable hepatic tumors: An evaluation of 112 patients

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Journal Article

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90 Y microsphere radioembolization; Liver metastases; Postradioembolization syndrome; Selective internal radiation therapy; Toxicity


Purpose: The aim of this study was to estimate the incidence of complications after 90Y microsphere radioembolization for unresectable hepatic tumors and evaluate risk factors for late complications. Methods and Materials: A cohort of 112 consecutive patients from two institutions underwent 90Y microsphere radioembolization for unresectable hepatic tumors. Complications were graded according to the Common Terminology Criteria for Adverse Events, version 3.0. Symptoms secondary to postradioembolization syndrome occurring within 30days were recorded as early complications, and all other complications were considered late complications. Results: Seventy-eight patients (70%) experienced postradioembolization syndrome, including fatigue, abdominal pain, nausea, vomiting, anorexia, or fever. Three patients (3%) experienced a Grade 3 early complication; no Grade 4 or 5 early toxicity occurred. Two patients (2%) experienced clinically significant liver dysfunction; 13 patients (12%), 27 patients (24%), and 9 patients (8%) had an elevation of bilirubin, aspartate aminotransferase, and alanine aminotransferase, respectively. Eleven patients (10%) experienced gastrointestinal ulceration, including two Grade 3 complications and one Grade 4 complication. Cholecystitis occurred in 7 patients (6%), including two Grade 3 complications. Grade 2 pancreatitis occurred in 1 patient (1%). No radiation pneumonitis was observed. The cumulative incidence of late Grade 3 or 4 complications at 12months after radioembolization was 8%. No Grade 5 toxicity occurred. Conclusions: 90Y microsphere radioembolization is a well-tolerated treatment for unresectable hepatic tumors with a low risk of Grade 3 or higher early or late toxicity. © 2013 American Brachytherapy Society.