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

How effective is Y-90 on liver cancer? ›

Yttrium-90 Radioembolization can control hepatocellular carcinoma well even in advanced diseases. Patients successfully downstaging/bridging to resection or transplantation have excellent overall survival.

How do I know if my Y-90 is working? ›

The interventional radiologist can advise you as to whether the procedure was a technical success when it is completed. Your interventional radiologist may recommend a follow-up visit. This visit may include a physical check-up, imaging exam(s) and blood tests.

Can Y-90 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.

How effective is radioembolization? ›

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.

How long is life expectancy with Y-90 treatment? ›

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 survival rate after Y-90 treatment? ›

After Y90, between 75 to 95% of patients will see an improvement in the liver and prolonged survival rates.

Does Y-90 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.

How long does Y-90 work? ›

These beads will stay in the blood vessels around your tumor(s). They will emit radiation for about 10 days. During this time, they will deliver very strong radiation directly to the tumor(s). Even after they are no longer radioactive, the beads still work for several months to kill the tumor.

Can Y-90 be repeated? ›

The goal of Y-90 SIRT is to destroy the tumor(s) within the liver. This typically happens after one treatment but treatments can be repeated if necessary to achieve complete tumor destruction.

Can you be around people after Y-90 treatment? ›

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 medication is 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.

What are the benefits of Y-90? ›

Painless for most people. Safe and well-tolerated. Able to deliver a higher radiation dose than external radiation therapy or radiation given outside the body. Helpful in preserving healthy tissue, as the radiation releases close to the tumor.

Is Y-90 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 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.

What is the survival rate for liver embolization? ›

Patients treated with hepatic arterial embolization demonstrate longer progression-free survival and have 5-year survival rates of nearly 30%. The safety of repeat embolizations has also been proven in the setting of recurrent symptoms or progression of the disease.

How long does Y90 work? ›

These beads will stay in the blood vessels around your tumor(s). They will emit radiation for about 10 days. During this time, they will deliver very strong radiation directly to the tumor(s). Even after they are no longer radioactive, the beads still work for several months to kill the tumor.

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.

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.

Can Y90 be repeated? ›

The goal of Y-90 SIRT is to destroy the tumor(s) within the liver. This typically happens after one treatment but treatments can be repeated if necessary to achieve complete tumor destruction.

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