Y-90 Selective Internal Radiation Therapy for Ocular Melanoma Metastatic to the Liver: Dosimetry and Response Assessment

Monday, March 6, 2023

12:00 PM – 1:00 PM

Location: Phoenix Convention Center, North Ballroom 120 D

Poster Presenter(s)

John C. Panagides, BS (he/him/his)

Medical Student
Harvard Medical School

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

Suvranu Ganguli, MD (he/him/his)

Chief, Interventional Radiology
Boston Medical Center/Boston University School of Medicine
Ronald Arellano, MD

Professor
Department of Radiology, Massachusetts General Hospital
XC

Xiaomin Chen, BS

Research Assistant
Massachusetts General Hospital
KM

Kamaneh Montazeri, MD

Instructor in Medicine, Harvard Medical School
Massachusetts General Hospital
RS

Ryan Sullivan, MD

Associate Professor, Harvard Medical School
Massachusetts General Hospital
EW

Eric Wehrenberg-Klee, MD

Faculty
Massachusetts General Hospital

Disclosure(s):

John C. Panagides, BS: No financial relationships to disclose

Suvranu Ganguli, MD: Avania: Advisory Committee or Review Panel Member (Ongoing); Boston Scientific: Advisory Committee or Review Panel Member (Ongoing), Consultant (Ongoing), Speaking and Teaching (Ongoing); Eisai: Advisory Committee or Review Panel Member (Ongoing), Consultant (Ongoing); Instylla: Advisory Committee or Review Panel Member (Ongoing), Consultant (Ongoing), Ownership Interest (Ongoing), Speaking and Teaching (Ongoing); Medtronic: Advisory Committee or Review Panel Member (Ongoing), Consultant (Ongoing), Speaking and Teaching (Ongoing); Sirtex: Advisory Committee or Review Panel Member (Ongoing), Consultant (Ongoing), Speaking and Teaching (Ongoing)

Ronald Arellano, MD: No financial relationships to disclose

Purpose:

Selective internal radiation therapy has been found to prolong overall survival in patients with ocular melanoma that is metastatic to the liver. However, the tumor-to-normal (T/N) ratio and dose to tumor have not been widely reported. The purpose of this study was to determine the T/N ratio, dose to tumor, and dose to normal liver in patients diagnosed with ocular melanoma metastatic to the liver.

Materials and Methods:

This retrospective cohort study was approved by our institutional IRB and included patients diagnosed with ocular melanoma with metastasis to the liver diagnosed between 2005 and 2020. All patients underwent Y90 selective internal radiation therapy (SIRT) with resin Y90 microspheres, with administered activity calculated at time of treatment using the BSA-method. 8/25 patients received treatment to both lobes for a total of 33 treated lobes. Retrospectively, the tumor-to-normal tissue (T/N) ratios were calculated for all patients from 99m Tc-MAA SPECT/CT using SurePlan Liver 90Y-dosimetry toolkit (v7.1; MIM Software). The partition method was used to calculate anticipated dose to normal liver as well as dose to tumor (Gy). Tumor response was assessed using RECIST criteria.

Results:

A total of 25 patients (15 female, mean age 67 +/- 13 years) were identified, with 33 treated liver lobes. Over half of patients received prior systemic therapy, and 7/25 patients had bilobar disease at the time of diagnosis of metastatic disease. 16 liver lobes demonstrated stable disease (SD) and 17 lobes demonstrated progressive disease (PD) on follow-up imaging. T/N ratios varied from 0.9 (min) to 10.2 (max) with a mean of 3.3 +/- 2.13. T/N ratio was not significantly different stratified according to RECIST outcome status (two-tailed t-test, p > 0.1).

Conclusion:

Limited data exist on the characteristics of ocular melanoma metastatic to the liver treated with salvage SIRT. T/N ratios and dose to tumor varied widely in this retrospective cohort study. Continued data collection and patient monitoring is warranted.