Intra-hepatic Abscopal Effect Following Radioembolization of Hepatic Metastases

Powerski, Maciej; Drewes, Ralph; Omari, Jazan; Relja, Borna; Surov, Alexey; Pech, Maciej

doi:10.1007/s00270-020-02612-4

by Maciej Powerski, Ralph Drewes, Jazan Omari, Borna Relja, Alexey Surov, Maciej Pech

Abstract:

PURPOSE: To search for abscopal effects (AE) distant to the site of radiation after sequential Yittrium-90 (Y-90) radioembolization (RE) of liver malignancies. METHODS AND MATERIALS: In this retrospective analysis, all patients treated by RE between 2007 and 2018 (n = 907) were screened for the following setting/conditions: sequential RE of left and right liver lobe in two sessions, liver-specific MRI (MRI1) acquired max. 10 days before or after first RE (RE1), liver-specific MRI (MRI2) acquired with a minimum time interval of 20 days after MRI1, but before second RE (RE2). No systemic tumor therapies between MRI1 and MRI2. No patients with liver cirrhosis. Metastases \textgreater 5 mm in untreated liver lobes were compared in MRI1 and MRI2 and rated as follows: same size or larger in MRI2 = no abscopal effect (NAE); \textgreater 30\% shrinkage without Y-90 contamination in SPECT/CT = abscopal effect (AE). RESULTS: Ninety six of 907 patients met aforementioned criteria. Median time-frame between RE1 and MRI2 was 34 (20-64) days. These 96 cases had 765 metastases which were evaluable (median 5(1-40) metastases per patient). Four patients could be identified with at least one shrinking metastasis of the untreated site: one patient with breast cancer (3 metastases: 0 NAE; 3 AE), one patient with prostate cancer (6 metastases: 3 NAE; 3 metastases \textgreater 30\% shrinkage but possible Y-90 contamination) and two patients with shrinkage of one metastasis each but less than 30\%. CONCLUSION: Our retrospective study documents AE after RE of liver tumors in 1 out of 96 cases, 3 other cases remain unclear.

Reference:

Intra-hepatic Abscopal Effect Following Radioembolization of Hepatic Metastases (Maciej Powerski, Ralph Drewes, Jazan Omari, Borna Relja, Alexey Surov, Maciej Pech), In Cardiovascular and interventional radiology, volume 43, 2020.

Bibtex Entry:

@article{powerski_intra-hepatic_2020,
	title = {Intra-hepatic {Abscopal} {Effect} {Following} {Radioembolization} of {Hepatic} {Metastases}},
	volume = {43},
	issn = {1432-086X 0174-1551 0174-1551},
	doi = {10.1007/s00270-020-02612-4},
	abstract = {PURPOSE: To search for abscopal effects (AE) distant to the site of radiation after  sequential Yittrium-90 (Y-90) radioembolization (RE) of liver malignancies. METHODS  AND MATERIALS: In this retrospective analysis, all patients treated by RE between  2007 and 2018 (n = 907) were screened for the following setting/conditions:  sequential RE of left and right liver lobe in two sessions, liver-specific MRI  (MRI1) acquired max. 10 days before or after first RE (RE1), liver-specific MRI  (MRI2) acquired with a minimum time interval of 20 days after MRI1, but before  second RE (RE2). No systemic tumor therapies between MRI1 and MRI2. No patients with  liver cirrhosis. Metastases {\textgreater} 5 mm in untreated liver lobes were compared in MRI1  and MRI2 and rated as follows: same size or larger in MRI2 = no abscopal effect  (NAE); {\textgreater} 30\% shrinkage without Y-90 contamination in SPECT/CT = abscopal effect  (AE). RESULTS: Ninety six of 907 patients met aforementioned criteria. Median  time-frame between RE1 and MRI2 was 34 (20-64) days. These 96 cases had 765  metastases which were evaluable (median 5(1-40) metastases per patient). Four  patients could be identified with at least one shrinking metastasis of the untreated  site: one patient with breast cancer (3 metastases: 0 NAE; 3 AE), one patient with  prostate cancer (6 metastases: 3 NAE; 3 metastases {\textgreater} 30\% shrinkage but possible Y-90  contamination) and two patients with shrinkage of one metastasis each but less than  30\%. CONCLUSION: Our retrospective study documents AE after RE of liver tumors in 1  out of 96 cases, 3 other cases remain unclear.},
	language = {eng},
	number = {11},
	journal = {Cardiovascular and interventional radiology},
	author = {Powerski, Maciej and Drewes, Ralph and Omari, Jazan and Relja, Borna and Surov, Alexey and Pech, Maciej},
	month = nov,
	year = {2020},
	pmid = {32808201},
	pmcid = {PMC7591411},
	keywords = {Abscopal effect, Radioembolization, SIRT},
	pages = {1641--1649}
}