y90 Treatment for Liver Cancer: Candidates, Success, Outlook (2024)

Y90 radioembolization involves placing radioactive capsules into the blood vessel feeding your tumor. It’s primarily used for cancer that can’t be treated with surgery or a liver transplant.

Each year, about 700,000 people worldwide receive a liver cancer diagnosis and about 600,000 people die from this type of cancer. Liver cancer tends to progress silently until it grows large or spreads. Most people with liver cancer are not eligible for potentially curative treatments such as surgery or a liver transplant.

Yttrium-90 (Y90) radioembolization, or selective internal radiotherapy, is an alternative treatment option for liver cancer that can’t be cured with typical treatments. The procedure involves placing radioactive beads into a blood vessel near your liver to block your tumor’s blood supply and destroy its cells.

Some research suggests that Y90 radioembolization may help increase the survival time of some people who have liver cancer that can’t be surgically removed.

Read on to learn more about how Y90 radioembolization is used to treat liver cancer.

Radioembolization is a combination of two techniques:

  • Radiation therapy: administering high energy waves to destroy cancer cells
  • Embolization: blocking a blood vessel that’s supplying a tumor

Researchers have been studying the effectiveness and safety of Y90 radioembolization since the 1960s. It has become a common treatment to help manage liver cancer or cancer that has spread to the liver that can’t be surgically removed.

Y90 radioembolization is a minimally invasive procedure that involves placing small glass or resin radioactive spheres into a blood vessel that’s supplying your tumor. Healthcare professionals insert the beads into your artery through a tube called a catheter.

These spheres travel through your blood vessel until they reach the tumor and emit radiation. This radiation travels a very short distance and primarily damages cancer cells while sparing healthy tissue.

Y90 radioembolization is a treatment option for people with liver cancer that can’t be treated with surgery or a liver transplant. It may also be administered to people who are awaiting a liver transplant to keep their cancer from spreading.

Compared to other treatments

Y90 radioembolization has emerged as an alternative treatment option to radiofrequency ablation and transarterial chemoembolization (TACE) for early stage liver cancer that can’t be treated with surgery.

Radiofrequency ablation is often the first treatment recommended for these tumors. It uses heat to destroy cancer cells. If radiofrequency ablation can’t be performed, the next treatment option is TACE, which involves blocking the hepatic artery and delivering chemotherapy medications.

TACE is also the standard of care for people with intermediate stage liver cancer. Y90 radioembolization is a potential alternative treatment.

Researchers are continuing to compare the effectiveness of Y90 radioembolization to that of other treatments. Clinical trials are ongoing.

SARAH trial

The 2017 phase 3 SARAH trial compared the effectiveness of Y90 radioembolization to that of the targeted therapy drug sorafenib for treating people with locally advanced or intermediate stage liver cancer after unsuccessful treatment with TACE.

The median overall survival didn’t significantly vary between groups. The group that received sorafenib had slightly higher rates of serious complications.

SIRveNIB trial

In a 2018 phase 3 clinical trial, researchers again compared Y90 radioembolization to sorafenib for people with locally advanced liver cancer.

As in the SARAH trial, overall survival didn’t significantly differ between the groups.

SORAMIC trial

In the phase 2 SORAMIC trial, researchers compared the effectiveness of sorafenib and Y90 radioembolization combined to the effectiveness of sorafenib alone.

They found that the addition of Y90 radioembolization didn’t improve overall survival. However, they did find evidence that it may improve survival in some of the subgroups they analyzed, such as:

  • people under 65
  • people without cirrhosis
  • people with non-alcohol-related cirrhosis

The survival rate for liver cancer in general is low. From 2012 to 2018, the 5-year relative survival rates in the United States were:

Stage5-year relative survival rate
localized36%
regional13%
distant3%
all stages21%

People who receive Y90 radioembolization tend to have low overall survival rates since they usually are not eligible for surgery. Studies have reported 1- and 2-year median survival rates around 80% and 65%, respectively, for people treated with Y90 radioembolization.

In the SARAH trial, half the people who received Y90 radioembolization with locally advanced or intermediate stage liver cancer after unsuccessful treatment with TACE survived at least 8 months. Half of those who received sorafenib lived for 9.9 months.

In the SIRveNIB trial, half the people with locally advanced liver cancer who received Y90 radioembolization survived 8.8 months, while those who received sorafenib survived 10 months.

A 2020 study found that the median survival was 27.2 months for people with metastatic liver-dominant neuroendocrine tumors who received Y90 radioembolization in the Canadian province of British Columbia.

Factors that influence liver cancer outlook

Factors linked to less favorable outcomes for people with liver cancer include:

Factors that have been associated with a less favorable outlook in people who received Y90 radioembolization include:

  • older age
  • later cancer stage
  • history of portal vein thrombosis

Y90 radioembolization is a liver cancer treatment option that involves injecting radioactive beads into a blood vessel that supplies the tumor. These beads release waves of energy that damage the cancer cells while leaving healthy cells largely undamaged.

Your doctor is most likely to recommend Y90 radioembolization if you have cancer that can’t be cured with surgery or a liver transplant. They may also recommend alternative treatments such as TACE or radiofrequency ablation.

y90 Treatment for Liver Cancer: Candidates, Success, Outlook (2024)

FAQs

What is the success rate of Y90 for liver cancer? ›

People who receive Y90 radioembolization tend to have low overall survival rates since they usually are not eligible for surgery. Studies have reported 1- and 2-year median survival rates around 80% and 65%, respectively, for people treated with Y90 radioembolization.

What is the response rate for Y90? ›

The disease control rate was 78.1%, the objective response rate was 65.6%, and the successful downstage rate was 34.4% (11 of 32). Nine of thirty-two patients underwent resection or transplantation after Yttrium-90 radioembolization with 2-year overall survival being 100%.

What is the life expectancy of a Y90 patient? ›

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.

How do I know if my Y90 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.

Can Y90 be curative? ›

The treatment is not a cure for cancer in the liver, but it has been shown to prolong lives for months or years and to greatly improve the quality of life of cancer patients. Patients experience few, if any, side effects from Y90 treatment, which is performed in an outpatient setting.

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.

Can Y-90 be repeated? ›

The current study shows that repeat treatment to the same hepatic arterial territory is as safe as single treatment to the same territory.

How long does Y-90 fatigue last? ›

Overall the treatment is very well tolerated with minimal side effects. The most common side effect is fatigue, which can last two to four weeks.

What to expect after Y-90 treatment? ›

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. Patients may have a temperature of up to 101º F (38.3º C) for 1 to 2 weeks after the procedure.

Is Y-90 palliative? ›

Y-90 radioembolisation is a palliative treatment for primary liver lesions and liver metastatic disease which uses ionising radiation to shrink tumours. It is generally used to relieve the symptoms of liver tumours rather than to cure the underlying condition.

Does Y-90 cause cirrhosis? ›

Y-90 RE-induced decompensated cirrhosis and liver failure is a rare but serious complication for patients with liver cancer and unresectable tumors. Those having undergone concurrent chemotherapy may be at higher risk.

What are the risks of Y-90? ›

These risks include damage to the blood vessel, bruising or bleeding at the puncture site, and infection. The doctor will take precautions to mitigate these risks. There is a small risk that the microspheres may lodge in the wrong place, which may result in an ulcer in the stomach or duodenum.

How long has Y-90 been around? ›

Yttrium-90 (Y90) was initially developed in the 1960s as a nonsystemic treatment for HCC.

What medications are given after Y-90? ›

Protonix (pantoprazole), a stomach acid reducer. This medication is to be taken for 90 DAYS to reduce the risk of developing a stomach and/or small intestine ulcer that could cause complications. 2. Zofran (ondansetron), is an anti-nausea medication that can be prescribed if nausea persists after the procedure.

How much does Y-90 cost? ›

The primary outcome was the overall difference in cost between Y-90 vs TACE for treatment of hepatocellular carcinoma at Einstein Medical Center. The price of a Y-90 ranges from $30,000 to $35,000 with an average of $32,500.

What is the best radiation for liver cancer? ›

Selective internal radiotherapy (SIRT) SIRT is a type of internal radiotherapy. It uses radioactive beads to treat cancer in the liver. It is sometimes called radioembolisation or trans arterial radioembolisation (TARE).

What is the best treatment for liver cancer in the world? ›

Liver Transplant Advances

Liver transplantation has proven to be the most effective treatment for patients with hepatocellular carcinoma, a common type of liver cancer. If a patient has liver disease, such as cirrhosis, liver transplantation can also further reduce further the risk of recurrence following treatment.

What are the side effects of Y90 treatment for liver cancer? ›

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. Patients may have a temperature of up to 101º F (38.3º C) for 1 to 2 weeks after the procedure.

What are the chances of curing liver cancer? ›

5-year relative survival rates for liver cancer
SEER* stage5-year relative survival rate
Localized37%
Regional14%
Distant4%
All SEER stages combined22%
Jan 17, 2024

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