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- Title
Transarterial Selective Internal Radiation Therapy with Yttrium-90 for Liver Metastatic Urothelial Carcinoma of the Ureter as a Bridging Therapy to Immunotherapy: A Case Report with a 10-Year Follow-Up.
- Authors
Schmid, Bruno Pagnin; Silva Cunha, Marcela Juliano; Moreira Valle, Leonardo Guedes; Galastri, Francisco Leonardo; Affonso, Breno Boueri; Falsarella, Priscila Mina; Kaliks Guendelmann, Rafael Aliosha; Garcia, Rodrigo Gobbo; Nasser, Felipe
- Abstract
Primary transitional cell carcinoma of the ureter is a rare type of cancer with metastasis presented in approximately 25% at diagnosis. Due to its rarity and poor prognosis, the management of this neoplasm is still controversial, and the development of new therapies is of uttermost importance. Herein, we describe a case of a 54-year-old patient diagnosed with transitional cell carcinoma of the left ureter submitted to left nephroureterectomy (pT3N2M0) and methotrexate, vinblastine, doxorubicin, and cisplatin adjuvant chemotherapy. A single liver metastasis was detected and combination chemotherapy with gemcitabine and carboplatin was initiated along with stereotactic body radiation therapy. Despite these 2 previous chemotherapy regimens, the patient presented disease progression and transarterial selective internal radiation therapy (SIRT) with yttrium-90 was indicated. This locoregional treatment was performed with the administration of 1.2 GBq yttrium-90 resin microspheres (SIR-Spheres®, Sirtex Medical Limited, Sydney, NSW, Australia) into the right hepatic artery. Another systemic treatment was immunotherapy using nivolumab with excellent tolerability. After 10 years of follow-up, at the last clinical evaluation, the patient had no clinical symptoms and the last imaging follow-up using positron emission tomography-computed tomography scan showed complete response. This report introduces upper urinary tract urothelial carcinoma as a distinct type of malignancy in which SIRT can be safely implemented. As a transition method to nivolumab, it was successful. There might be a potential therapeutic synergism between these 2 treatment modalities.
- Subjects
SYDNEY (N.S.W.); AUSTRALIA; POSITRON emission tomography computed tomography; RADIOTHERAPY; TRANSITIONAL cell carcinoma; STEREOTACTIC radiotherapy; IMMUNOTHERAPY; BLADDER cancer; RENAL cell carcinoma
- Publication
Case Reports in Oncology, 2023, Vol 16, Issue 1, p711
- ISSN
1662-6575
- Publication type
Article
- DOI
10.1159/000531787