The Toxicity of Liver Directed Yttrium-90 Microspheres in Primary and Metastatic Liver Tumors

Selective Internal Radiation (SIR) therapy with yttrium-90 microspheres has become an alternative approach to treat hepatic tumors.A single institution retrospective chart review was performed to assess the safety of SIR microspheres in twenty-one patients with hepatic malignancies. The yttrium-90 radiation dose was dependent upon the percentage of tumor involvement of the liver, with a dose modification (reduction) adjusted for macroaggregated albumin (MAA) shunted to the lung.Twenty-one patients underwent twenty-five treatments with SIR microsphere therapy for primary and metastatic liver tumors. One mortality was secondary to fulminant hepatic failure after developing radiation hepatitis. Morbidities included radiation hepatitis (1) and peptic ulcer disease (6).The application of SIR microspheres has been utilized for a variety of liver tumors. Although it has been a useful treatment option in selected patients, safety still remains an issue.