How 90Y Works and Why It's Important

 
 

The key to saving Anne Wolfe’s life was a treatment that wasn’t available a decade ago: radioembolization with Yttrium-90 (90Y).

Vanderbilt is among the top 10 percent of 90Y centers in the country. Daniel B. Brown, M.D., director of Interventional Oncology at Vanderbilt-Ingram Cancer Center, directs Vanderbilt’s 90Y research registry.

Radioembolization is a minimally invasive, outpatient procedure that combines radiation therapy and the ability to clog blood vessels to prevent blood flow and growth of cancer cells in the liver. The 90Y radioactive beads used to kill the tumors like Anne had are very high dose, delivered with precision into the patient’s liver through catheter tubing about as thin as pencil lead.

“This technique served two purposes,” Brown said. “We were able to treat the tumor in the right side of the liver by infusing tiny beads with embedded radioactive isotope 90Y inside the blood vessels feeding the tumor. This actually kept the tumor in check. It also blocked the blood supply to that portion of the liver, which in turn allowed the left side of the liver to grow in response.”

In Anne’s case, Brown and a team of colleagues came up with a plan for blocking blood flow and nutrients from getting to the diseased portion of her liver, which set the stage for the smaller healthy portion of the liver to regenerate. (The liver is the only solid organ in the human body that can do this.) This, in turn, set the stage for Anne to grow enough healthy liver so the cancerous portion could be removed.

Anne’s case was unusual, Brown said.

The most common use for 90Y is to help relieve pain and other symptoms for patients whose liver tumors cannot be removed surgically. “One of the nice things about this approach," Brown said, "is that people usually tolerate it very well, with limited toxicity, and it’s all outpatient.”