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ASCO Educational Book; 2009
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Intraarterial Yttrium-90 Microspheres for Hepatic Malignancies

Andrew S. Kennedy, MD, FACRO

From Wake Radiology Oncology Services, Cary, North Carolina

Author's disclosure of potential conflicts of interest are found at the end of this article.

Address reprint requests to Andrew S. Kennedy, MD, FACRO, Co-Medical Director, Wake Radiology Oncology Services, 300 Ashville Ave, Ste 110, Cary, North Carolina 27518; akennedy{at}wakerad.com

Overview: With the rise in popularity of radioactive yttrium-90 microspheres (radioembolization [RE]) for both primary and metastatic hepatic cancers, a review of its role in the treatment of colorectal liver metastases is presented. There are consistently good and encouraging results across all clinical reports (retrospective and prospective) regarding low acute or late toxicity, high response rates (positron emission tomography (PET), carcinoembryonic antigen, and Response Evaluation Criteria in Solid Tumors/World Health Organization [RECIST/WHO]), improved time to liver progression, and overall survival in the salvage therapy. Level 2a medical evidence supports RE use in metastatic and primary liver tumors. Although the phase III trials of RE in first-line treatment of patients with metastatic colorectal cancer are ongoing, there is sufficient phase II and retrospective clinical data supporting its use in salvage therapy for most patients with metastatic colorectal cancer.