Toxicity comparison of yttrium-90 resin and glass microspheres radioembolization

Abstract

Background: To investigate the clinical, hematological and biochemical toxicity differences between glass and resin yttrium-90 (⁹⁰Y)-microspheres radioembolization treatment of primary and metastatic liver disease.

Methods: Between May 2014 and November 2016 all consecutive glass and resin ⁹⁰Y microspheres radioembolization treatments were retrospectively analyzed. Biochemical, hematological and clinical data were collected at treatment day, two weeks, one month and three months follow-up. Post-treatment ⁹⁰Y PET/CTs were assessed for the absorbed doses in non-tumorous liver volume (D<inf>NTLV</inf>) and tumor volume (D<inf>TV</inf>). Biochemical, hematological and clinical toxicity were compared between glass and resin using chi square tests and repeated ANOVA measures. Biochemical and clinical toxicity was correlated with D<inf>NTLV,total</inf> by means of Pearson correlation and independent t-tests.

Results: A total of 85 patients were included (N.=44 glass, N.=41 resin). Clinical toxicity the day after treatment (i.e. abdominal pain [P=0.000], nausea [P=0.000] and vomiting [P=0.003]) was more prevalent for resin. Biochemical and hematological toxicities were similar for both microspheres. The D<inf>NTLV,total</inf> was significantly higher in patients with REILD grade ≥3 in the resin group (43.5 versus 33.3 Gy [P=0.050]). A similar non-significant trend was seen in the glass group: 95.0 versus 69.0 Gy [P=0.144].

Conclusions: The clinical, hematological and biochemical toxicity of radioembolization treatment with glass and resin is comparable, however, post-embolization syndrome related complaints are more common for resin.