1. 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.
- Author
-
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, and Nasser, Felipe
- Subjects
- *
POSITRON emission tomography computed tomography , *RADIOTHERAPY , *TRANSITIONAL cell carcinoma , *STEREOTACTIC radiotherapy , *IMMUNOTHERAPY , *BLADDER cancer , *RENAL cell carcinoma - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF