Radiology, Vol 147, 413-418, Copyright © 1983 by Radiological Society of North America
Work in progress: transcatheter embolization of renal cell carcinoma with radioactive infarct particles
EK Lang, J Sullivan and JB DeKernion
Treatment by radioactive infarct implant is advocated for patients who have
renal cell carcinoma with distant metastases. The radioactive infarct
implants were placed into the primary tumor, and when feasible into
metastases, by transcatheter embolization. Metastases to the skeleton,
liver, lungs, adrenals, and retroperitoneal muscles were also seeded;
metastases to the central nervous system, pancreas, and spleen, as well as
most pulmonary metastases, proved inaccessible to this approach. The
effectiveness of this treatment modality was shown by improved cumulative
survival rates (59% for patients with metastases and at risk at two years
and 50% for those at risk at five years). The best results were obtained
when treating patients who had skeletal metastases (90% survival of those
at risk at two years and 60% at five years). Measurable palliation factors,
such as decrease in the size of the primary lesion, weight gain, and
control of bleeding and pain, were indicators of treatment response and
were observed in the majority of patients. Remissions were signaled by
weight gain, normalization of the erythrocyte sedimentation rate, and
disappearance or decrease of tumor markers. Some evidence suggests that the
salutary results may be based on significant reduction of tumor burden,
temporary local control of tumor, and improved general immunocompetence.
