Table 3.

Yttrium-90 radioembolization in combination with second- or third-line chemotherapy.

Author	No. of patients	Trial design	Treatment	Response	Survival	Complications
Van Hazel et al. (34)	25	Prospective, dose escalation study	Irinotecan at 50, 75, or 100 mg/m2 on days 1 and 8 of a 3-week cycle for the first two cycles, and full irinotecan doses (i.e., 100 mg/m2) during cycles 3–9. Radioembolization during the first chemotherapy cycle	PR in 11 (48%) of 23, and SD in 9 (39%)	Median PFS: 6.0 months; Median OS: 12.2 months	Grades 3–4 events in three of six patients at 50 mg/m2 (obstructive jaundice, thrombocytopenia, and diarrhea), in five of 13 patients at 75 mg/m2 (neutropenia, leukopenia, thrombocytopenia, elevated alkaline phosphatase, abdominal pain, ascites, and fatigue) and in four of six patients at 100 mg/m2 (diarrhea, deep vein thrombosis, constipation, and leukopenia)
Lim et al. (35)	30	Prospective; all patients who failed initial 5-FU chemotherapy, 22 failed oxaliplatin or irinotecan also. EHD in 7	Radioembolization; concurrent 5FU in 21	PR in 10 (33%); SD in 8 (27%); no response in patients with poor performance status or with extra hepatic disease	TTP: 5.3 months	Duodenal/gastric ulcer in 13%. One death related to radiation hepatitis

CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; PFS, progression free survival; EHD, extra-hepatic disease; ORR, objective response rate; OS, overall survival; CEA, carcinoembryonic antigen; TTP, time to progression; HAC, hepatic arterial chemoinfusion.