Selective Transarterial Yttrium-90 Radioembolization for Hepatic Metastases: A Case Series

Abstract

Introduction. Transarterial radioembolization (TARE) with yttrium-90 represents an emerging locoregional therapy for hepatic malignancies of diverse histopathological origins. We present preliminary outcomes from nine patients with unresectable bilobar hepatic metastases treated with this modality.

Aim. To summarize our initial clinical experience with TARE in patients with histologically varied metastatic liver lesions.

Materials and Methods. Between December 2023 and October 2024, nine TARE procedures using yttrium-90 (⁹⁰Y) microspheres (1-1.3 GBq) were performed at Moscow Center for Restorative Treatment LLC. The cohort included metastases from colorectal (n=5), breast (n=2), gastric (n=1), and uveal melanoma (n=1) primaries. All patients had ECOG performance status 0-1 and demonstrated intolerance or insufficient response to 1-3 lines of prior systemic therapy.

Results. No procedure-related mortality or major complications occurred. Two patients experienced moderate, medically managed nausea and right subcostal region discomfort. At median follow-up of 6.5 months (range 3-11), disease stabilization was achieved in seven patients (77.8%). Two patients exhibited disease progression at 3-month imaging, demonstrating both existing lesion enlargement and new metastatic foci.

Conclusion. Yttrium-90 TARE demonstrated favorable safety outcomes in this heterogeneous cohort of patients with multiple hepatic metastases as part of a combined treatment approach. Further investigation is required to establish efficacy of this technique.