Background/Objectives: Over the past few years, high-dose radioembolization (≥150 Gy) has become widely adopted for the treatment of primary liver cancer, while evidence for its application in hepatic metastases is still limited. The aim of this study was to evaluate the safety and efficacy of high-dose transarterial radioembolization (TARE) in patients with hepatic metastases using resin Yttrium-90 (90Y) microspheres.Methods: In this retrospective analysis, patients who were treated with high-dose TARE for hepatic metastases with90Y resin microspheres between May 2019 and April 2025 were included. The primary outcomes were treatment efficacy and toxicity assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events v5.0. Treatment efficacy was evaluated based on radiological response according to Response Evaluation Criteria in Solid Tumors version 1.1, time to progression and overall survival (OS). Secondary outcomes included90Y PET/CT post-treatment voxel-based local deposition model dosimetry and its relations to response.Results: A total of 15 patients were included, with hepatic metastases originating from colorectal cancer (n= 11, 73.3%), neuroendocrine tumor (n= 3, 20%) and breast cancer (n= 1, 6.7%). Seven patients (47.7%) had undergone one or multiple prior loco(regional) liver treatments and 13 (86.7%) patients had prior systemic therapy. The median mean tumor absorbed dose was 160.7 Gy (IQR 127.6–245.0 Gy), and the median normal liver parenchyma dose was 40.3 Gy (IQR 21.7–52.3 Gy). Disease control was achieved in all patients, with partial response in 10 patients (66.7%) and stable disease in 5 patients (33.3%) after 3 months. The median OS was 26.5 months (95% CI 24.5 months to no estimate). Two patients (13.3%) experienced grade 3 laboratory toxicity. No grade 4 or 5 toxicities were observed.Conclusions: High-dose TARE with90Y resin microspheres resulted in a high disease control rate and demonstrated a favorable safety profile, even in this heavily pretreated cohort.
背景/目的：近年来，高剂量（≥150 Gy）放射栓塞治疗已广泛应用于原发性肝癌的治疗，但其在肝转移瘤中的应用证据仍有限。本研究旨在评估使用树脂钇-90（⁹⁰Y）微球进行高剂量经动脉放射栓塞治疗肝转移瘤患者的安全性和有效性。方法：本回顾性分析纳入了2019年5月至2025年4月期间接受⁹⁰Y树脂微球高剂量TARE治疗的肝转移瘤患者。主要结局指标是根据美国国家癌症研究所不良事件通用术语标准5.0版评估的治疗有效性和毒性。治疗有效性基于实体瘤疗效评价标准1.1版的影像学反应、疾病进展时间和总生存期进行评估。次要结局指标包括基于⁹⁰Y PET/CT治疗后体素局部沉积模型的剂量测定及其与治疗反应的关系。结果：共纳入15例患者，肝转移瘤原发灶为结直肠癌（11例，73.3%）、神经内分泌肿瘤（3例，20%）和乳腺癌（1例，6.7%）。7例患者（47.7%）既往接受过一次或多次局部（区域）肝脏治疗，13例患者（86.7%）既往接受过全身治疗。肿瘤中位平均吸收剂量为160.7 Gy（四分位距127.6–245.0 Gy），正常肝实质中位剂量为40.3 Gy（四分位距21.7–52.3 Gy）。所有患者均实现疾病控制，3个月后部分缓解10例（66.7%），疾病稳定5例（33.3%）。中位总生存期为26.5个月（95% CI 24.5个月至无法估计）。2例患者（13.3%）出现3级实验室毒性。未观察到4级或5级毒性。结论：即使在这个经过大量前期治疗的队列中，使用⁹⁰Y树脂微球进行高剂量TARE治疗仍能实现较高的疾病控制率，并展现出良好的安全性。
High-Dose Transarterial Radioembolization of Hepatic Metastases Using Yttrium-90 Resin Microspheres
肿瘤(癌症)患者之家