Class Complication/Toxicity Incidence (%) Reference Management
Constitutional Fatigue 28-52 22,69,71 Self Limiting
Steroid
  Abdominal Pain/discomfort 16-19 22,69,71 Self Limiting
Steroid
Analgesics
  Nausea 6-13 22,71 Steroid
Antiemetics
Hepatic/Tumor Vasculature Gastritis 5 10 Analgesics
Antiemetics
Bismuth
Motility Agent
H2 blocker or PPI
  Cholecystitis
(1% requiring surgery),
case reports
13-15 Observation
Cholecystectomy
  Radiation Pneumonitis 0-6 35,38 High dose steroids
Hepatic Parenchyma Biochemical Liver Toxicity: Grade III or higher
(ALP, AST, ALT, bilirubin) (transient)
6-27 22,43,44 Self Limiting
  Radiation Induced Liver Disease (RILD) or failure 0-20 20,44,45,70 High dose steroids
  Portal Hypertension; Fibrosis Case Reports 13,19,72 Observational
TIPS
  Biloma/abscess 1 14 Observational
Drainage
  Ascites 11 (advanced liver disease) 69 Drainage
  Encephalopathy 3 cases (more common after second treatment) 44 Lactulose
Supportive
  Hemobilia Single reported case 44  
Systemic Toxicities Pancytopenia Case Report (likely due to free Yttrium-90 unbound to microsphere) 73 Supportive
Tabe 1: Summary of commonly encountered toxicities, reported incidents, and potential management options.