Background: Evaluation of radioembolisation with ittrium 90 (Y90) in patients with liver metastis, not responsive to chemotherapy. Two years experience.

Methods: In a period of 23 months from february 2005 to december 2006, we treated 49 patients with liver metastis from colon neoplasm (22), breast (16), stomach (3), pancreas (3), cholangiocarcinoma (2), melanoma (1), bronchial carcinoid (1), esophagus (1). All patients treated arrived to our observation with disease progression, despite undergoig different major/minor surgical or micro-invasive percutaneous procedures; (RFA,PEI,etc) which were then followed by lines of unsuccessful chemotherapy. Patients underwent a preliminary abdominal CT, body PET and hepatic angiography followed by coiling GDA artery and aberrant branches. At the end of procedure were injected Technetium Tc 99m Aggregated Albumin through the hepatic artery. From our experience, we excluded fron treatment patients with bilirubin level superior of 1.8 mg, and patients with pulmonary shunt over 20%, but not patients with extra-hepatic metastasis. On treatment day, under fluoroscopy guide, we implanted the dosage of Y90 microspheres calculated on the basis of liver tumor involvement and BSA formula. The patients is kept under observation for 18-24 hours in the nuclear medicine department. In all cases, the patients were discharged the day after treatment.

Results: In all cases we obtained a reduction and/or normalization of tumor markers in a period of between 4 and 8 weeks, and partial and/or total remission of liver mets in PET control (table 1). A patient with bilirubin level of 1.7 mg died of hepatic failure, 30 days after treatment. We observed 1 cholecistitis treated with medical therapy; and 2 major gastritis with abdominal pain for 4-6 weeks after treatment.

Conclusions: Our two years experience about radioembolisation with Y90 confirms that use of Y90 SIR spheres is a viable and safe method to treat liver mets with acceptable levels of complications and good response rates.

Results in 23 months

PET responce	Biomarkers	Status
41/49 (83.6%)	39/49 (79.5%)	33/49 (67.3%)
25/41 +++	12/39 +++	alive
10/41 ++	15/39 ++
6/41 +	12/39 +