Yttrium-90 radioembolisation for treatment of colorectal cancer liver metastases

Abstract

The thesis includes a systematic review on yttrium-90 radioembolisation (Y90-RE) and two chapters on the pre-treatment work-up of eligible patients, i.e. on the added value of FDG-PET imaging and on activity planning. The main research project consisted of a prospective cohort study in which 42 patients with colorectal cancer liver metastases were enrolled. Prior to and after treatment with Y90-RE, blood samples were collected. Several angiogenic factors were analyzed and a significant increase in plasma values of angiopoietin-2 and hepatocyte growth factor were demonstrated in patients with rapidly progressive disease. This suggests that the concomitant use of anti-angiogenic treatment with Y90-RE may increase response rates. Within this cohort study, dose-response relationship and quality of life were also investigated. A strong dose-response relationship was demonstrated, and higher doses are required for more metabolically active lesions. Quality of life did not deteriorate significantly and relatively little side effects were reported.