⁹⁰Y-Radioembolisation – Evidenz bei hepatozellulärem und kolorektalem Karzinom

Zusammenfassung

Die RE mit Yttrium 90 Mikrosphären hat sich als wertvolle lokoregionäre Therapie in der individuellen Behandlung einzelner Stadien des HCC und des hepatisch metastasierten CRC etabliert und füllt häufig therapeutische Lücken anderer lokaler Therapien, wobei die Evidenzlage teilweise noch zu schwach ist, als dass die RE Einzug in die Leitlinien gefunden hat. Aufgrund von laufenden prospektiven Studien ist hier jedoch in naher Zukunft ein Wandel zu erwarten. Bis dahin sollte die Indikation zur RE primär durch einen interdiszplinären Tumorboardbeschluss gestellt werden und – wenn möglich – in einem Studienrahmen durchgeführt werden.

• Literatur

• 1 Campbell AM, Bailey IH, Burton MA. Tumour dosimetry in human liver following hepatic yttrium-90 microsphere therapy. Phys Med Biol 2001; 46: 487-498
• 2 Kennedy AS, Nutting C, Coldwell D. Pathologic response and microdosimetry of (90)Y microspheres in man: review of four explanted whole livers. Int J Radiat Oncol Biol Phys 2004; 60: 1552-1563
• 3 Crissien AM, Frenette C. Current management of hepatocellular carcinoma. Gastroenterol Hepatol (NY) 2014; 10: 153-161
• 4 Ba SsalamahA, Grünberger T, Hoffmann M. Diagnose, Stadieneinteilung und Behandlung des hepatozellulären Karzinoms (interdisziplinär). Wien: Comprehensive Cancer Center Vienna; 2012
• 5 Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology 2011; 53: 1020-1022
• 6 Llovet JM, Di Bisceglie AM, Bruix J. Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst 2008; 100: 698-711
• 7 Rahman A, Assifi MM, Pedroso FE. Is resection equivalent to transplantation for early cirrhotic patients with hepatocellular carcinoma? J Gastrointest Surg. A meta-analysis 2012; 16: 1897-1909
• 8 Rampone B, Schiavone B, Martino A. Current management strategy of hepatocellular carcinoma. World J Gastroenterol 2009; 15: 3210-3216
• 9 Cabibbo G, Maida M, Genco C. Survival of patients with hepatocellular carcinoma (HCC) treated by percutaneous radio-frequency ablation (RFA) is affected by complete radiological response. PLoS One 2013; 8: e70016
• 10 Cucchetti A, Piscaglia F, Cescon M. Cost-effectiveness of hepatic resection versus percutaneous radiofrequency ablation for early hepatocellular carcinoma. J Hepatol 2013; 59: 300-307
• 11 Wang Y, Luo Q, Li Y. Radiofrequency ablation versus hepatic resection for small hepatocellular carcinomas: a meta-analysis of randomized and nonrandomized controlled trials. PLoS One 2014; 9: e84484
• 12 Cho YK, Rhim H, Noh S. Radiofrequency ablation versus surgical resection as primary treatment of hepatocellular carcinoma meeting the Milan criteria: a systematic review. J Gastroenterol Hepatol 2011; 26: 1354-1360
• 13 Mazzaferro V, Regalia E, Doci R. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996; 334: 693-699
• 14 Yao FY, Xiao L, Bass NM. Liver transplantation for hepatocellular carcinoma: validation of the UCSF-expanded criteria based on preoperative imaging. Am J Transplant 2007; 7: 2587-2596
• 15 Llovet JM, Ricci S, Mazzaferro V. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008; 359: 378-390
• 16 Pinter M, Sieghart W, Graziadei I. Sorafenib in unresectable hepatocellular carcinoma from mild to advanced stage liver cirrhosis. Oncologist 2009; 14: 70-76
• 17 Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology 2003; 37: 429-442
• 18 Lammer J, Malagari K, Vogl T. Prospective randomized study of doxorubicin-eluting-bead embolization in the treatment of hepatocellular carcinoma: results of the PRECISION V study. Cardiovasc Intervent Radiol 2010; 33: 41-52
• 19 Vogl TJ, Lammer J, Lencioni R. Liver, gastrointestinal, and cardiac toxicity in intermediate hepatocellular carcinoma treated with PRECISION TACE with drug-eluting beads: results from the PRECISION V randomized trial. AJR Am J Roentgenol 2011; 197: W562-W570
• 20 Llovet JM, Real MI, Montana X. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet 2002; 359: 1734-1739
• 21 Lo CM, Ngan H, Tso WK. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology 2002; 35: 1164-1171
• 22 Hu HT, Kim JH, Lee LS. Chemoembolization for hepatocellular carcinoma: multivariate analysis of predicting factors for tumor response and survival in a 362-patient cohort. J Vasc Interv Radiol 2011; 22: 917-923
• 23 Burrel M, Reig M, Forner A. Survival of patients with hepatocellular carcinoma treated by transarterial chemoembolisation (TACE) using Drug Eluting Beads. Implications for clinical practice and trial design. J Hepatol 2012; 56: 1330-1335
• 24 Chen CH, Hu FC, Huang GT. Applicability of staging systems for patients with hepatocellular carcinoma is dependent on treatment method – analysis of 2010 Taiwanese patients. Eur J Cancer 2009; 45: 1630-1639
• 25 Lewandowski RJ, Mulcahy MF, Kulik LM. Chemoembolization for hepatocellular carcinoma: comprehensive imaging and survival analysis in a 172-patient cohort. Radiology 2010; 255: 955-965
• 26 Wang JH, Changchien CS, Hu TH. The efficacy of treatment schedules according to Barcelona Clinic Liver Cancer staging for hepatocellular carcinoma – survival analysis of 3892 patients. Eur J Cancer 2008; 44: 1000-1006
• 27 Sangro B, Carpanese L, Cianni R. Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma across Barcelona clinic liver cancer stages: a European evaluation. Hepatology 2011; 54: 868-878
• 28 Oliveri RS, Wetterslev J, Gluud C. Transarterial (chemo)embolisation for unresectable hepatocellular carcinoma. Cochrane Database Syst Rev 2011; CD004787
• 29 Forner A, Llovet JM, Bruix J. Chemoembolization for intermediate HCC: Is there proof of survival benefit?. J Hepatol 2012; 56: 984-986
• 30 Akamatsu M, Yoshida H, Obi S. Evaluation of transcatheter arterial embolization prior to percutaneous tumor ablation in patients with hepatocellular carcinoma: a randomized controlled trial. Liver Int 2004; 24: 625-629
• 31 Doffoel M, Bonnetain F, Bouche O. Multicentre randomised phase III trial comparing Tamoxifen alone or with Transarterial Lipiodol Chemoembolisation for unresectable hepatocellular carcinoma in cirrhotic patients (Federation Francophone de Cancerologie Digestive 9402). Eur J Cancer 2008; 44: 528-538
• 32 Pelletier G, Roche A, Ink O. A randomized trial of hepatic arterial chemoembolization in patients with unresectable hepatocellular carcinoma. J Hepatol 1990; 11: 181-184
• 33 Hilgard P, Hamami M, Fouly AE. Radioembolization with yttrium-90 glass microspheres in hepatocellular carcinoma: European experience on safety and long-term survival. Hepatology 2010; 52: 1741-1749
• 34 Salem R, Lewandowski RJ, Mulcahy MF. Radioembolization for hepatocellular carcinoma using Yttrium-90 microspheres: a comprehensive report of long-term outcomes. Gastroenterology 2010; 138: 52-64
• 35 Iñarrairaegui M, Thurston KG, Bilbao JI. Radioembolization with use of yttrium-90 resin microspheres in patients with hepatocellular carcinoma and portal vein thrombosis. J Vasc Interv Radiol 2010; 21: 1205-1212
• 36 D’Avola D, Lnarrairaegui M, Bilbao JI. A retrospective comparative analysis of the effect of Y90-radioembolization on the survival of patients with unresectable hepatocellular carcinoma. Hepatogastroenterology 2009; 56: 1683-1688
• 37 Salem R, Lewandowski RJ, Kulik L. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology 2011; 140: 497-507 e492
• 38 Lewandowski RJ, Kulik LM, Riaz A. A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant 2009; 9: 1920-1928
• 39 Ferlay J, Parkin DM, Steliarova-Foucher E. Estimates of cancer incidence and mortality in Europe in 2008. Eur J Cancer 2010; 46: 765-781
• 40 Society AC. Colorectal cancer facts & figures 2011–2013. Atlanta: American Cancer Society; 2011
• 41 Andre T, Boni C, Mounedji-Boudiaf L. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med 2004; 350: 2343-2351
• 42 Manfredi S, Lepage C, Hatem C. Epidemiology and management of liver metastases from colorectal cancer. Ann Surg 2006; 244: 254-259
• 43 Stangl R, Altendorf-Hofmann A, Charnley RM. Factors influencing the natural history of colorectal liver metastases. Lancet 1994; 343: 1405-1410
• 44 Bengtsson G, Carlsson G, Hafstrom L. Natural history of patients with untreated liver metastases from colorectal cancer. Am J Surg 1981; 141: 586-589
• 45 Gray BN. Colorectal cancer: the natural history of disseminated disease – a review. Aust N Z J Surg 1980; 50: 643-646
• 46 Fong Y, Fortner J, Sun RL. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 1999; 230: 309-318 ; discussion 318–321
• 47 Khatri VP, Chee KG, Petrelli NJ. Modern multimodality approach to hepatic colorectal metastases: solutions and controversies. Surg Oncol 2007; 16: 71-83
• 48 Nordlinger B, Guiguet M, Vaillant JC. Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer 1996; 77: 1254-1262
• 49 Nordlinger B, Sorbye H, Glimelius B. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet 2008; 371: 1007-1016
• 50 Welsh FK, Tekkis PP, O’Rourke T. Quantification of risk of a positive (R1) resection margin following hepatic resection for metastatic colorectal cancer: an aid to clinical decision-making. Surg Oncol 2008; 17: 3-13
• 51 Scheele J, Stangl R, Schmidt K. Recurrent tumor after R0 resection of colorectal liver metastases. Incidence, resectability and prognosis. Chirurg 1995; 66: 965-973
• 52 Hochster HS, Hart LL, Ramanathan RK. Safety and efficacy of oxaliplatin and fluoropyrimidine regimens with or without bevacizumab as first-line treatment of metastatic colorectal cancer: results of the TREE Study. J Clin Oncol 2008; 26: 3523-3529
• 53 Van Cutsem E, Kohne CH, Lang I. Cetuximab plus irinotecan, fluorouracil, and leucovorin as first-line treatment for metastatic colorectal cancer: updated analysis of overall survival according to tumor KRAS and BRAF mutation status. J Clin Oncol 2011; 29: 2011-2019
• 54 Van Cutsem E, Tabernero J, Lakomy R. Addition of aflibercept to fluorouracil, leucovorin, and irinotecan improves survival in a phase III randomized trial in patients with metastatic colorectal cancer previously treated with an oxaliplatin-based regimen. J Clin Oncol 2012; 30: 3499-3506
• 55 Grothey A, Van Cutsem E, Sobrero A. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet 2013; 381: 303-312
• 56 Van Cutsem E, Kohne CH, Hitre E. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med 2009; 360: 1408-1417
• 57 Douillard JY, Oliner KS, Siena S. Panitumumab-FOLFOX4 treatment and RAS mutations in colorectal cancer. N Engl J Med 2013; 369: 1023-1034
• 58 Adam R, Delvart V, Pascal G. Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg 2004; 240: 644-657 ; discussion 657–648
• 59 Adam R, Wicherts DA, de Haas RJ. Patients with initially unresectable colorectal liver metastases: Is there a possibility of cure?. J Clin Oncol 2009; 27: 1829-1835
• 60 Folprecht G, Gruenberger T, Bechstein WO. Tumour response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: the CELIM randomised phase 2 trial. Lancet Oncol 2010; 11: 38-47
• 61 Giacchetti S, Itzhaki M, Gruia G. Long-term survival of patients with unresectable colorectal cancer liver metastases following infusional chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin and surgery. Ann Oncol 1999; 10: 663-669
• 62 Folprecht G, Grothey A, Alberts S. Neoadjuvant treatment of unresectable colorectal liver metastases: correlation between tumour response and resection rates. Ann Oncol 2005; 16: 1311-1319
• 63 Falcone A, Ricci S, Brunetti I. Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol 2007; 25: 1670-1676
• 64 Fornaro L, Lonardi S, Masi G. FOLFOXIRI in combination with panitumumab as first-line treatment in quadruple wild-type (KRAS, NRAS, HRAS, BRAF) metastatic colorectal cancer patients: a phase II trial by the Gruppo Oncologico Nord Ovest (GONO). Ann Oncol 2013; 24: 2062-2067
• 65 Bridgewater J, Adam R, Chau I. Updated efficacy/safety findings from a randomized, phase 2 study of bevacizumab plus mFOLFOX6 or FOLFOXIRI in patients with initially unresectable liver metastases from colorectal cancer (OLIVIA study). European Cancer Congress 2013; Abstract 2159
• 66 Falcone A, Cremolini C, Masi G. FOLFOXIRI/bevacizumab (bev) versus FOLFIRI/bev as first-line treatment in unresectable metastatic colorectal cancer (mCRC) patients (pts): Results of the phase III TRIBE trial by GONO group. Journal of Clinical Oncology 2013; ASCO Annual Meeting Abstracts; Abstract 3505
• 67 Schmoll HJ, Van Cutsem E, Stein A. ESMO Consensus Guidelines for management of patients with colon and rectal cancer. a personalized approach to clinical decision making. Ann Oncol 2012; 23: 2479-2516
• 68 Hendlisz A, Van den Eynde M, Peeters M. Phase III trial comparing protracted intravenous fluorouracil infusion alone or with yttrium-90 resin microspheres radioembolization for liver-limited metastatic colorectal cancer refractory to standard chemotherapy. J Clin Oncol 2010; 28: 3687-3694
• 69 Seidensticker R, Denecke T, Kraus P. Matched-pair comparison of radioembolization plus best supportive care versus best supportive care alone for chemotherapy refractory liver-dominant colorectal metastases. Cardiovasc Intervent Radiol 2012; 35: 1066-1073
• 70 Bester L, Meteling B, Pocock N. Radioembolization versus standard care of hepatic metastases: comparative retrospective cohort study of survival outcomes and adverse events in salvage patients. J Vasc Interv Radiol 2012; 23: 96-105
• 71 Cosimelli M, Golfieri R, Cagol PP. Multi-centre phase II clinical trial of yttrium-90 resin microspheres alone in unresectable, chemotherapy refractory colorectal liver metastases. Br J Cancer 2010; 103: 324-331
• 72 Gray B, Van Hazel G, Hope M. Randomised trial of SIR-Spheres plus chemotherapy vs. chemotherapy alone for treating patients with liver metastases from primary large bowel cancer. Ann Oncol 2001; 12: 1711-1720
• 73 Van Hazel G, Blackwell A, Anderson J. Randomised phase 2 trial of SIR-Spheres plus fluorouracil/leucovorin chemotherapy versus fluorouracil/leucovorin chemotherapy alone in advanced colorectal cancer. J Surg Oncol 2004; 88: 78-85
• 74 Sharma RA, Van Hazel GA, Morgan B. Radioembolization of liver metastases from colorectal cancer using yttrium-90 microspheres with concomitant systemic oxaliplatin, fluorouracil, and leucovorin chemotherapy. J Clin Oncol 2007; 25: 1099-1106
• 75 Gulec SA, Pennington K, Wheeler J. Yttrium-90 microsphere-selective internal radiation therapy with chemotherapy (chemo-SIRT) for colorectal cancer liver metastases: an in vivo double-arm-controlled phase II trial. Am J Clin Oncol 2013; 36: 455-460
• 76 Seidensticker R, Seidensticker M, Damm R. Hepatic toxicity after radioembolization of the liver Uusing Y-90-microspheres: sequential lobar versus whole liver approach. Cardiovasc Intervent Radiol 2012; 35: 1109-1118
• 77 Mansmann U, Sartorius U, Laubender R. Quantitative analysis of the impact of deepness of response on post-progression survival time following first-line treatment in patients with mCRC. Journal of Clinical Oncology 2013; ASCO Annual Meeting Abstracts; Abstract 3630
• 78 Kosmider S, Tan TH, Yip D. Radioembolization in combination with systemic chemotherapy as first-line therapy for liver metastases from colorectal cancer. J Vasc Interv Radiol 2011; 22: 780-786
• 79 Kennedy AS, Ball D, Cohen S. Multicenter comparison of safety and efficacy of yttrium-90 resin microsperes in elderly (> 70 years) and younger patients with unresectable liver-dominant metastastic colorectal cancer. Cardiovascular and Interventional Radiology Society of Europe Meeting. 2013 Abstract 3109.5
• 80 Sangro B, Gil-Alzugaray B, Rodriguez J. Liver disease induced by radioembolization of liver tumors: description and possible risk factors. Cancer 2008; 112: 1538-1546
• 81 Farthing MJ, Clark ML, Sloane JP. Liver disease after bone marrow transplantation. Gut 1982; 23: 465-474
• 82 Lawrence TS, Robertson JM, Anscher MS. Hepatic toxicity resulting from cancer treatment. Int J Radiat Oncol Biol Phys 1995; 31: 1237-1248
• 83 McDonald GB, Sharma P, Matthews DE. The clinical course of 53 patients with venocclusive disease of the liver after marrow transplantation. Transplantation 1985; 39: 603-608
• 84 Forrest DL, Thompson K, Dorcas VG. Low molecular weight heparin for the prevention of hepatic veno-occlusive disease (VOD) after hematopoietic stem cell transplantation: a prospective phase II study. Bone Marrow Transplant 2003; 31: 1143-1149
• 85 McDonald GB, Sharma P, Matthews DE. Venocclusive disease of the liver after bone marrow transplantation: diagnosis, incidence, and predisposing factors. Hepatology 1984; 4: 116-122
• 86 Shulman HM, Hinterberger W. Hepatic veno-occlusive disease – liver toxicity syndrome after bone marrow transplantation. Bone Marrow Transplant 1992; 10: 197-214
• 87 Gil-Alzugaray B, Chopitea A, Inarrairaegui M. Prognostic factors and prevention of radioembolization-induced liver disease. Hepatology 2013; 57: 1078-1087
• 88 Ingold JA, Reed GB, Kaplan HS. Radiation hepatitis. Am J Roentgenol Radium Ther Nucl Med 1965; 93: 200-208
• 89 Kim TH, Panahon AM, Friedman M. Acute transient radiation hepatitis following whole abdominal irradiation. Clin Radiol 1976; 27: 449-454
• 90 Reed Jr GB, Cox Jr AJ. The human liver after radiation injury. A form of veno-occlusive disease. Am J Pathol 1966; 48: 597-611
• 91 Fajardo LF, Berthrong M. Radiation injury in surgical pathology. Part I. Am J Surg Pathol 1978; 2: 159-199
• 92 Fajardo LF, Colby TV. Pathogenesis of veno-occlusive liver disease after radiation. Arch Pathol Lab Med 1980; 104: 584-588
• 93 Lewin K, Millis RR. Human radiation hepatitis. A morphologic study with emphasis on the late changes. Arch Pathol 1973; 96: 21-26
• 94 Rubin P. The Franz Buschke lecture: late effects of chemotherapy and radiation therapy: a new hypothesis. Int J Radiat Oncol Biol Phys 1984; 10: 5-34
• 95 Sempoux C, Horsmans Y, Geubel A. Severe radiation-induced liver disease following localized radiation therapy for biliopancreatic carcinoma: activation of hepatic stellate cells as an early event. Hepatology 1997; 26: 128-134
• 96 Geraci JP, Mariano MS. Radiation hepatology of the rat: parenchymal and nonparenchymal cell injury. Radiation Res 1993; 136: 205-213
• 97 Jirtle RL, Michalopoulos G, McLain JR. Transplantation system for determining the clonogenic survival of parenchymal hepatocytes exposed to ionizing radiation. Cancer Res 1981; 41: 3512-3518
• 98 Johnson LK, Longenecker JP, Fajardo LF. Differential radiation response of cultured endothelial cells and smooth myocytes. Anal Quant Cytol 1982; 4: 188-198
• 99 Kennedy AS, McNeillie P, Dezarn WA. Treatment parameters and outcome in 680 treatments of internal radiation with resin 90Y-microspheres for unresectable hepatic tumors. Int J Radiat Oncol Biol Phys 2009; 74: 1494-1500