Lit Review

http://www.jvir.org/article/S1051-0443(14)01751-5/abstract

Thereaspheres, not SRX. But some good data all the same. Out of 15 this is rather good.
'The best radiologic response of treated liver metastases was 12 patients with complete response, 1 patient with partial response and 1 patient with stable disease by mRECIST criteria. '

Purpose

To determine safety and efficacy of transarterial yttrium-90 (490Y) glass microsphere radioembolization in patients with liver dominant metastatic renal cell carcinoma (RCC).
Materials and Methods

This is a single institution retrospective study of patients with liver dominant metastasic RCC treated with radioembolization from May 2010 to April 2014. All patients included in this study underwent radical nephrectomy and received systemic chemotherapy prior to radioembolization. Retrospective review of electronic medical records and imaging studies was performed to evaluate clinical and biochemical toxicities and overall survival. Radiologic response of liver metastasis was evaluated in cross sectional imaging (CT or MRI) and was categorized according to modified Response Evaluation Criteria In Solid Tumors (mRECIST).
Results

A total of 15 patients were identified (11 males, 4 females) with a median age of 67 years. Bilobar disease was present in 9 patients, while 6 patients had unilobar or segmental disease. One patient developed recurrent disease and received a second lobar treatment. The average dose delivered was 144.3+36.1 Gy (mean+SD). There was no major complication only grade 1 and 2 toxicities were recorded in all patients, mostly fatigue and anorexia. The median overall survival was 46.1 months (95% CI 9.2-not reached). The median progression free survival was 4.9 months (95% CI 1-8.2) which represented mostly extrahepatic progression. The best radiologic response of treated liver metastases was 12 patients with complete response, 1 patient with partial response and 1 patient with stable disease by mRECIST criteria. One patient did not have contrast-enhanced study and had stable disease by RECIST criteria.
Conclusion

Transarterial 490Y radioembolization is a safe and effective treatment option to treat RCC hepatic metastases.