Author: Marisa Healy, BSN, RN
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Last Reviewed: July 03, 2023
Y-90 radioembolization (RE) is a procedure that combines internal (inside your body) radiation therapy and embolization (cutting off blood supply). It may also be called “selective internal radiation therapy” or “radioembolization.” There are 2 brand names of this therapy: TheraSphere and SIR-Spheres.
What is Y-90?
Yttrium-90 (Y-90) is a radioactive substance. This means it gives off radiation. It is attached to tiny beads that are smaller than a human hair. These beads are injected into the main artery that brings blood to the liver. The beads get trapped in the tumor and in the small blood vessels that bring blood to the tumor(s).
How does Y-90 work?
Y-90 radioembolization works in two ways:
- The beads block off blood vessels, preventing blood flow to the tumor. This is called embolization. Cutting off the blood supply helps kill cancer cells.
- The beads get stuck in the tumor(s) and give off a high dose of radiation to the tumor tissue around them. This kills the tumor but limits the damage to healthy tissue around the tumor.
The beads are left in place and do not need to be removed. Most of the radiation is given off over about 10-14 days after the procedure. The radiation wears off completely by 30 days after the procedure.
What cancers can be treated with Y-90 RE?
Y-90 RE beads are used to treat hepatocellular (liver) cancer or other cancers that have spread (metastasized) to the liver.
How is the radioembolization done?
RE is done by a specialist called an interventional radiologist in the interventional radiology (IR) department or in the operating room (OR). Your provider will tell you how to prepare for the procedure, what medications you cannot take before the procedure, and any restrictions you will have. Y-90 RE is usually done as an outpatient procedure so that you can go home after.
Before the Y-90 RE procedure, you will have an arteriogram. During the arteriogram, the interventional radiologist will create a map of the arteries and blood flow in your abdomen (belly). They may place tiny coils in certain arteries to block them off from the Y-90 beads. A “tracer” is given to simulate (act out) the Y-90 procedure and scans are taken to make sure the plan is correct.
For the procedure, you will lie on your back and be connected to a monitor to track blood pressure, heart rate, and oxygen levels. You will have an IV placed in your hand or arm and will be given medication to make you sleepy and relaxed.
The provider will numb your groin area where the catheter will be inserted. X-rays are used to guide the catheter to the hepatic artery (the main artery that feeds the liver). The Y-90 beads are injected into the catheter and make their way to the tumor. You may feel pressure when the catheter is inserted or some discomfort when the beads are inserted.
The catheter is removed, and pressure is applied to the groin area to prevent bleeding. The whole procedure takes about an hour. You will be look after closely in the recovery room before you can go home.
What can I expect after the procedure?
After the procedure some people have:
- Fatigue that lasts for several weeks after treatment.
- A low fever (less than 100.4°F or 38.0°C) for a week after treatment.
- Nausea, vomiting, and loss of appetite.
- Pain from the blood supply being cut off to the area. This can be treated with pain medicines. If these symptoms don’t get better, talk with your care team.
- If you have pain in your abdomen that lasts more than 6-8 hours, you may have an ulcer in your stomach or small bowel. This can be caused by any coils that were placed to block off arteries from the Y-90 beads. Your provider will give you medicines to treat this.
You will receive medications during and after the procedure to help with these symptoms.
What restrictions do I have after the procedure?
For the week after your procedure, you will need to limit your contact with other people. This is because they can be exposed to the radiation in your body. For about the first week, you should:
- Limit close contact with others.
- Not sleep in the same bed as your partner.
- Not sit next to anyone for more than 2 hours.
- Not come in close contact with children or pregnant women.
Talk to your care team about when you can return to normal activities.
When should I call my care team?
You should call your care team after the procedure if you have:
- Bleeding, redness, or drainage from the area where the catheter went in.
- Fever greater than 100.4°F or 38.0°C.
- Pain that continues more than a week after treatment or is not relieved with pain medication.
- If you develop jaundice (yellowing of the skin or eyes) or a swollen belly (ascites) up to 3 months after treatment as this can be a sign of liver disease.
FAQs
The Effects of Radioembolization
Radioembolization also has been shown to shrink hepatocellular carcinomas. So far there is a small amount of evidence that people who get radioembolization and chemotherapy for cancer in the liver live longer than people receiving chemotherapy only.
What is the life expectancy of Y-90 patients? ›
While the patients treated with Y-90 radioembolization with chemotherapy, ranged from 43%-74% (about 29 months survival expectancy); in comparison to patients having received a traditional form of treatment.
What is the success of Y-90? ›
After the Y90 radioembolization, 9 of 32 (28.1%) patients received subsequent surgery including LT and surgical resection with 2-year OS, 1-year and 2-year disease-free survival being 100%, 96.9% and 93.8%, respectively (median follow-up time 20.6 months).
What happens after the Y-90 procedure? ›
Side effects following Y-90 may include: Mild to severe fatigue for up to 3 weeks after the procedure. Mild pain in the upper right side of the abdomen that may spread to the shoulder or back. Patients may experience nausea and decreased appetite for several days.
How long does radioembolization last? ›
The radiation's effects may continue to work for many weeks, even after the radiation can no longer be measured outside the body. The harmless beads remain in the body.
Does Y90 shrink tumors? ›
This refers to the radioactive isotope yttrium-90 that is inserted into tiny glass beads and injected into the tumor's blood supply. The radioactive beads accumulate inside the tumors and emit radiation to suppress tumor growth. Over time, the tumor dies, but the healthy part of the liver remains unaffected.
What are the complications of Y90 radioembolization? ›
Patients may experience a mild PRS that consists of the following clinical symptoms: fatigue, nausea, vomiting, anorexia, fever, abdominal discomfort, and cachexia. Hospitalization is usually not required.
Is Y90 treatment painful? ›
Radioembolization is generally painless; however, some patients may experience brief pain when the microspheres are injected.
What is the survival benefit of Y90? ›
Patients with CP class A (85%) had a median progression-free survival (PFS) of 3 months (95% CI: 2.99–5.55) and median OS of 17 months (95% CI: 9.59–23.10) from date of Y90 treatment compared to a median PFS of 4 months (95% CI: 2.07–8.28) and OS of 8 months (95% CI: 4.60–15.64) for patients with CP class B.
What type of radiation is Y-90? ›
Yttrium-90 internal radiation therapy is a treatment for some inoperable cancers. Doctors also refer to Yttrium-90 internal radiation therapy as selective internal radiation therapy (SIRT) or brachytherapy. Yttrium-90 is a radioactive isotope, a chemical element that gives off radiation.
Yttrium-90 (90Y) is a radioisotope derived from the decay of 90Sr. Yttrium-90 decays due to the emission of β- particles, with a half-life of 2.67 days 5. It has no gamma energy emission, but may be imaged through the use of bremsstrahlung interactions with planar or SPECT imaging.
What is yttrium-90 made of? ›
Production. Yttrium-90 is produced by the nuclear decay of strontium-90 which has a half-life of nearly 29 years and is a fission product of uranium used in nuclear reactors. As the strontium-90 decays, chemical high-purity separation is used to isolate the yttrium-90 before precipitation.
Do you have to stay away from people after Y-90? ›
After treatment with Y-90 radioactive material, you will emit a small amount of radiation. These levels are quite low. After treatment, you have no special precautions to follow to limit exposing other people to radiation. It is safe for people to be around you.
What is the recovery for radioembolization? ›
After the procedure
Imaging is performed on the day of the procedure to confirm the location within the liver where the radiation particles have been deposited. For the next week you may experience a low-grade fever, lethargy, or fatigue. Pain is not a common side effect of the procedure.
How do I know if my Y-90 is working? ›
Once the catheter reaches your liver, Dr. Christenson will take pictures with x-ray to see how the blood flows to your liver. Based on how the blood flows, Dr. Christenson will be able to tell if Y-90 Radiotherapy will work for you or not.
Is radioembolization painful? ›
Radioembolization is generally painless; however, some patients may experience brief pain when the microspheres are injected. Pain may develop in certain tumors over days to weeks due to normal inflammation related to tumor treatment.
What is the most common adverse effect from radioembolization? ›
After the procedure, some patients experience side effects called post-emobilization syndrome. The symptoms of this syndro,e include fatigue, fever, nausea, and vomiting. Patients may also experience pain after the procedure due to the ischemia of the treated area.
Is Y90 better than chemoembolization? ›
Radioembolization (Y-90) is very similar to chemoembolization but uses radioactive microspheres which are tiny beads instead of chemotherapy drugs as the payload to kill cancer cells.
How much does it cost to get a radioembolization? ›
Results: The costs approached $17,000 for transarterial chemoembolization versus $31,000 or $48,000 for unilobar or bilobar radioembolization, respectively.
