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VARIOUS › THERAPEUTIC RADIOPHARMACEUTICALS › ANTIINFLAMMATORY AGENTS › Yttrium (90Y) compounds
yttrium (90Y) silicate colloid
V10AA03
Forms & Strengths
- Sterile colloidal suspension of 90Y silicate microspheres
- Vial sizes typically 20‑30 GBq (0.5‑0.8 Ci) per vial
- Administered as intra‑arterial hepatic infusion
Adult Dosing
- Hepatocellular carcinoma: 1.5‑2.5 GBq total activity, calculated to deliver 80‑120 Gy to non‑tumorous liver tissue
- Colorectal liver metastases: up to 3.0 GBq total activity, dose individualized by liver volume and tumor burden
- Activity calculated using body surface area or partition model; infusion performed over 5‑10 min via catheter positioned in hepatic artery
- Pre‑procedure hepatic angiography and 99mTc‑MAA scan required to assess pulmonary shunt fraction (<20 % recommended)
Pediatric Dosing
- Not routinely recommended; use only in clinical trials or compassionate use
- If used, activity scaled to body surface area (≈0.5‑0.8 GBq/m²) with same safety assessments as adults
Indications
- Unresectable hepatocellular carcinoma in patients not candidates for surgical resection or transplant
- Unresectable liver‑dominant metastases from colorectal cancer after failure of systemic therapy
- Selective internal radiation therapy (SIRT) for liver‑confined malignancies
Mechanism of Action
- Beta‑emitting 90Y microspheres lodge in tumor microvasculature causing high‑dose, short‑range radiation (~2.5 mm)
- Radiation induces double‑strand DNA breaks and tumor cell apoptosis
- Embolic effect reduces arterial blood flow to tumor, augmenting radiation dose
Contraindications
- Severe liver dysfunction (Child‑Pugh C)
- Main portal vein thrombosis without adequate collateral flow
- Excessive hepatopulmonary shunt (>20 % of injected activity)
- Uncorrected gastrointestinal reflux of microspheres
- Known hypersensitivity to the microsphere components
Adverse Reactions
- Post‑embolization syndrome: fever, fatigue, abdominal pain, nausea/vomiting
- Radiation‑induced liver disease (RILD): ascites, jaundice, elevated bilirubin
- Transient elevation of liver enzymes (AST/ALT)
- Gastrointestinal ulceration or gastritis from non‑target microsphere deposition
- Pneumonitis if pulmonary shunt exceeds limits
- Transient thrombocytopenia or leukopenia
Drug Interactions
- Concurrent hepatotoxic agents (e.g., high‑dose acetaminophen, methotrexate) may exacerbate liver injury
- Anticoagulants/antiplatelet drugs increase risk of post‑procedure bleeding
- Chemotherapy given within 2‑4 weeks may potentiate bone‑marrow suppression
Curated Content: Needs Vetting Before Put to Clinical Use