Transarterial Yttrium-90 Glass Microsphere Radioembolization of Chemotherapy-Refractory Breast Cancer Liver Metastases: Results of a Single Institution Retrospective Study
Purpose: Our purpose was to retrospectively evaluate the safety and efficacy of transarterial hepatic radioembolization (TARE) treatment with yttrium-90 labeled glass microspheres in patients with chemotherapy-refractory breast cancer with liver-dominant metastatic disease. Methods and Materials: Th...
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2022
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oai:doaj.org-article:2f74ad0e84814633ae43295babdba3e22021-11-26T04:36:38ZTransarterial Yttrium-90 Glass Microsphere Radioembolization of Chemotherapy-Refractory Breast Cancer Liver Metastases: Results of a Single Institution Retrospective Study2452-109410.1016/j.adro.2021.100838https://doaj.org/article/2f74ad0e84814633ae43295babdba3e22022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2452109421001962https://doaj.org/toc/2452-1094Purpose: Our purpose was to retrospectively evaluate the safety and efficacy of transarterial hepatic radioembolization (TARE) treatment with yttrium-90 labeled glass microspheres in patients with chemotherapy-refractory breast cancer with liver-dominant metastatic disease. Methods and Materials: This retrospective single-institution study evaluated 31 female patients (mean age of 59.6 ± 13.2 years) who were treated with TARE. All patients received and progressed on systemic chemotherapy before TARE. Twenty-one patients also had extrahepatic metastases, including 13 patients who had metastases in bones only besides the liver. Survival data were analyzed by Kaplan-Meier method and compared using log-rank test. Imaging response to treatment was determined by Response Evaluation Criteria in Solid Tumors. Results: Median overall survival (OS) from the TARE was 13 months (95% confidence interval, 9.1-16.9 months). The survival probability at 1, 2, and 3 years was 60.1%, 36.7%, and 24.5%, respectively. The median hepatic progression-free survival was 7 months (95% confidence interval, 6.1-7.9 months). There was no 30-day mortality and 3 patients (9.4%) had grade 3 toxicity. Estrogen receptor (ER) positive status predicted prolonged survival (14 months for ER+ vs 9 months for ER-; P = .028). Patients who had bone-only extrahepatic disease had higher OS than patients with extraosseous metastases (23 vs 8 months, P = .02). At the 3-month follow-up the radiographic objective response rate was 46.6% and disease control rate was 70%. Conclusions: The treatment of patients with liver-dominant chemotherapy-refractory breast cancer metastases with TARE using yttrium-90 labeled glass microspheres is safe and led to promising hepatic disease control and OS especially in patients with ER+ tumors and in patients without extrahepatic extraosseous metastases.Elie Barakat, MDAndras Bibok, MDAnupam Rishi, MDAltan Ahmed, MDJessica M. Frakes, MDSarah E. Hoffe, MDAvan J. Armaghani, MDAixa E. Soyano, MDRicardo L.B. Costa, MDGhassan El-Haddad, MDJunsung Choi, MDBela Kis, MD, PhDElsevierarticleMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENAdvances in Radiation Oncology, Vol 7, Iss 1, Pp 100838- (2022) |
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Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 |
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Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Elie Barakat, MD Andras Bibok, MD Anupam Rishi, MD Altan Ahmed, MD Jessica M. Frakes, MD Sarah E. Hoffe, MD Avan J. Armaghani, MD Aixa E. Soyano, MD Ricardo L.B. Costa, MD Ghassan El-Haddad, MD Junsung Choi, MD Bela Kis, MD, PhD Transarterial Yttrium-90 Glass Microsphere Radioembolization of Chemotherapy-Refractory Breast Cancer Liver Metastases: Results of a Single Institution Retrospective Study |
| description |
Purpose: Our purpose was to retrospectively evaluate the safety and efficacy of transarterial hepatic radioembolization (TARE) treatment with yttrium-90 labeled glass microspheres in patients with chemotherapy-refractory breast cancer with liver-dominant metastatic disease. Methods and Materials: This retrospective single-institution study evaluated 31 female patients (mean age of 59.6 ± 13.2 years) who were treated with TARE. All patients received and progressed on systemic chemotherapy before TARE. Twenty-one patients also had extrahepatic metastases, including 13 patients who had metastases in bones only besides the liver. Survival data were analyzed by Kaplan-Meier method and compared using log-rank test. Imaging response to treatment was determined by Response Evaluation Criteria in Solid Tumors. Results: Median overall survival (OS) from the TARE was 13 months (95% confidence interval, 9.1-16.9 months). The survival probability at 1, 2, and 3 years was 60.1%, 36.7%, and 24.5%, respectively. The median hepatic progression-free survival was 7 months (95% confidence interval, 6.1-7.9 months). There was no 30-day mortality and 3 patients (9.4%) had grade 3 toxicity. Estrogen receptor (ER) positive status predicted prolonged survival (14 months for ER+ vs 9 months for ER-; P = .028). Patients who had bone-only extrahepatic disease had higher OS than patients with extraosseous metastases (23 vs 8 months, P = .02). At the 3-month follow-up the radiographic objective response rate was 46.6% and disease control rate was 70%. Conclusions: The treatment of patients with liver-dominant chemotherapy-refractory breast cancer metastases with TARE using yttrium-90 labeled glass microspheres is safe and led to promising hepatic disease control and OS especially in patients with ER+ tumors and in patients without extrahepatic extraosseous metastases. |
| format |
article |
| author |
Elie Barakat, MD Andras Bibok, MD Anupam Rishi, MD Altan Ahmed, MD Jessica M. Frakes, MD Sarah E. Hoffe, MD Avan J. Armaghani, MD Aixa E. Soyano, MD Ricardo L.B. Costa, MD Ghassan El-Haddad, MD Junsung Choi, MD Bela Kis, MD, PhD |
| author_facet |
Elie Barakat, MD Andras Bibok, MD Anupam Rishi, MD Altan Ahmed, MD Jessica M. Frakes, MD Sarah E. Hoffe, MD Avan J. Armaghani, MD Aixa E. Soyano, MD Ricardo L.B. Costa, MD Ghassan El-Haddad, MD Junsung Choi, MD Bela Kis, MD, PhD |
| author_sort |
Elie Barakat, MD |
| title |
Transarterial Yttrium-90 Glass Microsphere Radioembolization of Chemotherapy-Refractory Breast Cancer Liver Metastases: Results of a Single Institution Retrospective Study |
| title_short |
Transarterial Yttrium-90 Glass Microsphere Radioembolization of Chemotherapy-Refractory Breast Cancer Liver Metastases: Results of a Single Institution Retrospective Study |
| title_full |
Transarterial Yttrium-90 Glass Microsphere Radioembolization of Chemotherapy-Refractory Breast Cancer Liver Metastases: Results of a Single Institution Retrospective Study |
| title_fullStr |
Transarterial Yttrium-90 Glass Microsphere Radioembolization of Chemotherapy-Refractory Breast Cancer Liver Metastases: Results of a Single Institution Retrospective Study |
| title_full_unstemmed |
Transarterial Yttrium-90 Glass Microsphere Radioembolization of Chemotherapy-Refractory Breast Cancer Liver Metastases: Results of a Single Institution Retrospective Study |
| title_sort |
transarterial yttrium-90 glass microsphere radioembolization of chemotherapy-refractory breast cancer liver metastases: results of a single institution retrospective study |
| publisher |
Elsevier |
| publishDate |
2022 |
| url |
https://doaj.org/article/2f74ad0e84814633ae43295babdba3e2 |
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