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metastatic breast cancer radioembolization

Aurelio Castrellon, Steven M Nguyen, Federico Bengoa, Ana Botero, Luis E Raez
Metastatic triple-negative breast cancer (TNBC) constitutes a heterogeneous group of diseases with systemic treatment options limited to cytotoxic chemotherapy at the time being. The disease tends to affect visceral organs more frequently when compared to hormone receptor-positive breast cancer. The prognoses of patients with heavily pretreated disease affecting the liver are very dismal. We present the response to radioembolization and systemic chemotherapy in a seriously ill patient who had undergone previous lines of chemotherapy for TNBC with extensive liver metastases...
June 28, 2017: Curēus
K J Paprottka, F Schoeppe, M Ingrisch, J Rübenthaler, N N Sommer, E De Toni, H Ilhan, M Zacherl, A Todica, P M Paprottka
PURPOSE: To determine pre-therapeutic predictive factors for overall survival (OS) after yttrium (Y)-90 radioembolization (RE). METHODS: We retrospectively analyzed the pre-therapeutic characteristics (sex, age, tumor entity, hepatic tumor burden, extrahepatic disease [EHD] and liver function [with focus on bilirubin and cholinesterase level]) of 389 consecutive patients with various refractory liver-dominant tumors (hepatocellular carcinoma [HCC], cholangiocarcinoma [CCC], neuroendocrine tumor [NET], colorectal cancer [CRC] and metastatic breast cancer [MBC]), who received Y-90 radioembolization for predicting survival...
July 2017: European Journal of Nuclear Medicine and Molecular Imaging
Claus Christian Pieper, Carsten Meyer, Alois Martin Sprinkart, Wolfgang Block, Hojjat Ahmadzadehfar, Hans Heinz Schild, Petra Mürtz, Guido Matthias Kukuk
PURPOSE: To evaluate prognostic values of clinical and diffusion-weighted magnetic resonance imaging-derived intravoxel incoherent motion (IVIM) parameters in patients undergoing primary radioembolization for metastatic breast cancer liver metastases. SUBJECTS AND METHODS: A total of 21 females (mean age 54 years, range 43-72 years) with liver-dominant metastatic breast cancer underwent standard liver magnetic resonance imaging (1.5 T, diffusion-weighted imaging with b-values of 0, 50, and 800 s/mm(2)) before and 4-6 weeks after radioembolization...
2016: OncoTargets and Therapy
Minzhi Xing, Steven Lahti, Nima Kokabi, David M Schuster, Juan C Camacho, Hyun S Kim
OBJECTIVE: The aim of this study was to investigate pre-90Y lung shunt fraction (LSF) as a prognostic factor for overall survival (OS) in 90Y (resin/glass) planning 99mTc-MAA hepatopulmonary shunt studies for primary (hepatocellular carcinoma [HCC], intrahepatic cholangiocarcinoma) and metastatic liver tumors. METHODS: A total of 366 consecutive patients with primary and metastatic liver tumors underwent pre-90Y shunt study and 90Y radioembolization (mean age, 59...
January 2016: Clinical Nuclear Medicine
Andrew Kuei, Sammy Saab, Sung-Ki Cho, Stephen T Kee, Edward Wolfgang Lee
The liver is a common site of metastasis, with essentially all metastatic malignancies having been known to spread to the liver. Nearly half of all patients with extrahepatic primary cancer have hepatic metastases. The severe prognostic implications of hepatic metastases have made surgical resection an important first line treatment in management. However, limitations such as the presence of extrahepatic spread or poor functional hepatic reserve exclude the majority of patients as surgical candidates, leaving chemotherapy and locoregional therapies as next best options...
July 21, 2015: World Journal of Gastroenterology: WJG
Andre De Souza, Kevin Pelham Daly, James Yoo, Muhammad Wasif Saif
Background. When associated with isolated four or fewer liver foci, metastatic colorectal cancer is amenable to surgical resection. Alternative therapeutic methods for isolated liver metastases include radioembolization with yttrium 90 (Y90) and transarterial chemoembolization (TACE). We present here a case of a patient with two sites of liver metastatic disease from colorectal cancer who underwent Y90 radioembolization combined with aflibercept and FOLFIRI. Case Report. A 56-year-old female with history of bilateral breast cancer and metastatic colon cancer with prior hemicolectomy and 4 previous chemotherapy regimens developed liver metastasis...
2015: Case Reports in Oncological Medicine
Omar Zurkiya, Suvranu Ganguli
As a relatively safe outpatient procedure, radioembolization can potentially be used to treat any type of tumor within the liver, primary or metastatic. The safety and effectiveness of radioembolization in the treatment of hepatocellular carcinoma (HCC) and metastatic colorectal cancer (mCRC) has led many groups to explore its application in other malignancies. Moreover, other organs, such as the lungs and kidneys, have been explored as targets for therapy. Although the most data for radioembolization is related to HCC and mCRC, there is increasing experience and data regarding metastatic disease to the liver for other primary tumors...
2014: Frontiers in Oncology
Andrew Kennedy
Unresectable primary and metastatic liver tumors are a leading cause of cancer mortality and morbidity. This remains a challenging and key task for every oncologist despite significant advances that have been made with selective targeted systemic agents and in technology advances with radiotherapy delivery. Radioembolization (RE) is a technique of permanently implanting microspheres containing Yttrium-90 ((90)Y), a beta-emitting isotope with a treatment range of 2 mm, into hepatic tumors. This form of brachytherapy utilizes the unique dual vascular anatomy of the liver to preferentially deliver radioactive particles via the hepatic artery to tumor, sparing normal liver parenchyma...
June 2014: Journal of Gastrointestinal Oncology
Philipp M Paprottka, G P Schmidt, C G Trumm, R T Hoffmann, M F Reiser, T F Jakobs
PURPOSE: In clinical trials with yttrium-90-resin-microspheres for the management of colorectal cancer liver metastases, it was observed that radioembolization might result in splenomegaly and an increase in portal vein size. Subclinical hepatitis in normal liver tissue as well as the effects of radioembolization and prior chemotherapy are suspected to be responsible for this phenomenon. The purpose of this study was to quantify the changes in liver and spleen volume and portal vein diameter after radioembolization...
October 2011: Cardiovascular and Interventional Radiology
Ralf Thorsten Hoffmann, P Paprottka, T F Jakobs, C G Trumm, M F Reiser
Treatment of primary and secondary hepatic malignancies with transarterial chemoembolization (TACE) represents an essential component of interventional oncology known for many years and performed by many interventional radiologists first in primary liver tumors and nowadays even in metastases of different origins. Radioembolization (RE) has been introduced to the clinical arsenal of cytoreductive modalities in recent years. There is growing evidence for efficiency in liver tumors of various entities, with the most prominent ones being hepatocellular carcinoma, colorectal cancer, and neuroendocrine tumors...
December 2011: Abdominal Imaging
Andrew S Kennedy, Riad Salem
Radioembolization using radioactive yttrium-90-labeled microspheres is gaining a stronger foothold in the management of primary and metastatic hepatic cancers. The expanding literature reveals good and encouraging results in both retrospective and prospective reports as demonstrated by low acute or late toxicity and high response rates. This treatment modality, which is most beneficial in patients with good liver reserve and low Eastern Cooperative Oncology Group performance status, has led to improved time to liver progression and extended overall patient survival...
March 2010: Cancer Journal
R T Hoffmann, T F Jakobs, C H Kubisch, H J Stemmler, C Trumm, K Tatsch, T K Helmberger, M F Reiser
This retrospective study analyzes, whether patients suffering from extensive hepatic metastatic disease treated with SIRT can become suitable candidates for RFA.Within 38 months 46 patients (26 female, 20 male; age 32-75 years) bearing an extensive hepatic metastatic disease were treated with SIRT. Patients suffered from metastases of breast cancer (16/46), colorectal cancer (CRC) (21/46), neuroendocrine (3/46), and other primary carcinomas (6/46). The indication for SIRT was otherwise untreatable metastases confined to the liver...
April 2010: European Journal of Radiology
Jourdan E Stuart, Benjamin Tan, Robert J Myerson, Jose Garcia-Ramirez, Sreekrishna M Goddu, Thomas K Pilgram, Daniel B Brown
PURPOSE: The use of radioembolization of hepatic metastases with yttrium-90 ((90)Y) microspheres is increasing. The present report describes the outcomes in a cohort of patients with metastatic liver tumors treated with a resin-based microsphere agent. MATERIALS AND METHODS: Thirty patients with colon (n = 13), breast (n = 7), and other primary cancers (n = 10) were treated after the failure of first- and second-line therapy. Overall survival (OS), time to progression (TTP), and time to treatment failure (TTTF) were calculated from the first treatment...
October 2008: Journal of Vascular and Interventional Radiology: JVIR
Gregory J Dubel, Gregory M Soares
Selective internal radiation therapy involves the intra-arterial delivery of radioactive beads to the tumor while minimizing dosing to the adjacent organ. Because this technique invariably results in some degree of embolization, it has also been termed radioembolization. More than 8000 patients have been treated worldwide, with a large body of experience with primary hepatocellular carcinoma (HCC) and metastatic colorectal carcinoma (MCRC) and growing experience with other tumors (metastatic neuroendocrine, breast carcinoma, cholangiocarcinoma)...
October 2008: Surgical Oncology Clinics of North America
Affaan K Bangash, Bassel Atassi, Virginia Kaklamani, Thomas K Rhee, Maurice Yu, Robert J Lewandowski, Kent T Sato, Robert K Ryu, Vanessa L Gates, Steven Newman, Robert Mandal, William Gradishar, Reed A Omary, Riad Salem
PURPOSE: To present data from patients with breast cancer liver metastases who underwent radioembolization with yttrium (90Y) microspheres. MATERIALS AND METHODS: Using standard 90Y lobar treatment protocol, 27 female patients with progressing liver metastases on standard of care polychemotherapy were treated under an open-label phase 2 protocol. After treatment, we assessed (a) tumor response using computed tomography and/or positron emission tomography, (b) biochemical toxicity, and (c) survival...
May 2007: Journal of Vascular and Interventional Radiology: JVIR
Daniel Rubin, Charles Nutting, Bonita Jones
In 1993, a 54-year-old woman was diagnosed with early-stage breast adenocarcinoma and treated with doxorubicin and cyclophosphamide followed by tamoxifen. Nine years later, the patient presented for integrative treatment, with liver metastases. Carcinoembryonic antigen was significantly elevated. The patient was started on a heavily fractionated, multiple-agent chemotherapy regimen; however, she underwent significant adverse effects and the treatment was suspended. She then started on intravenous nutrition along with specific nutritional supplements...
September 2004: Integrative Cancer Therapies
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