Same-Day versus Multiday Planning/Treatment Radioembolization with Yttrium-90 Resin Microspheres in Patients with Liver Cancer ≥5 cm.

Purpose: To compare the safety and effectiveness of resin microsphere same-day planning/treatment radioembolization with conventional multiday radioembolization for treating liver cancer ≥5 cm.

Materials and methods: This single-center retrospective study included 80 patients who tried same-day radioembolization and 120 patients who received multiday radioembolization with resin microspheres between January 2022 and December 2023. For same-day radioembolization, once operators determined the required number and activity of vials, daughter vials were dispensed from a mother vial in the hospital nuclear medicine facility and then delivered to the angiography room. Tumor responses and toxicity between same-day radioembolization and multiday radioembolization were compared using the chi-square test.

Results: Among 80 patients who were scheduled to receive same-day radioembolization, 4 were excluded because of a high estimated lung dose, leading to the rejection of the radioembolization procedure. The remaining 76 patients (median tumor size, 8.3 cm) were treated with resin microspheres, using a median activity of 2.7 GBq. The median time interval from the initiation of planning angiography to the completion of radioembolization was 215 minutes. Among patients with hepatocellular carcinoma, the objective response rates by modified Response Evaluation Criteria in Solid Tumors were 87.7% (50/57) for same-day radioembolization and 89.2% (99/111) for multiday radioembolization (P = .776). The overall incidences of Grade 3 or higher adverse events were 15.8% (12/76) for same-day radioembolization and 21.7% (26/120) for multiday radioembolization (P = .312).

Conclusions: Same-day planning/treatment radioembolization with resin microspheres is as effective and safe as multiday radioembolization for large liver tumors ≥5 cm.