John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


Selective internal radiation therapy for colorectal liver metastases Volume 29, issue 4, April 2022


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1 Unicancer, Institut Bergonié, Oncologie médicale, 229 cours de l’Argonne, 33076 Bordeaux Cedex
2 Unicancer, Institut Bergonié, Médecine nucléaire, 229 cours de l’Argonne, 33076 Bordeaux Cedex
3 Unicancer, Institut Bergonié, Radiopharmacie, 229 cours de l’Argonne, 33076 Bordeaux Cedex
4 Unicancer, Institut Bergonié, Radiophysique, 229 cours de l’Argonne, 33076 Bordeaux Cedex
5 Unicancer, Institut Bergonié, Radiologie interventionnelle, 229 cours de l’Argonne, 33076 Bordeaux Cedex
* Correspondance : S. Pernot

Radioembolization of colorectal cancer liver metastases, or selective internal radiation therapy, is a technique that consists of delivering radioactive yttrium-loaded microbeads through the hepatic artery directly into the liver metastases. The therapeutic effect of radioembolization is related to the internal radiotherapy and not to the embolization. It requires several rigorous steps, involving interventional radiologists, nuclear physicians, radiopharmacists and radiophysicists: A simulation step with albumin macroaggregates, dosimetry, and the treatment phase. Radioembolization is available in France for about ten years. It has been validated in patients with exclusive liver metastases and refractory to systemic treatments in few studies with small population, allowing its reimbursement in this indication. Recent large phase III studies have evaluated this technique in combination with chemotherapy, in 1st and 2nd line of treatment. Despite clear antitumor activity, showing an improvement in local control, these studies did not show any benefit in overall survival. Improved dosimetry techniques, better patient selection, and combinations with treatments likely to have synergistic biological effects could lead to reconsideration of the role of radioembolization in early-line treatment.