We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Twelve-year experience of radioembolization for colorectal hepatic metastases in 214 patients: survival by era and chemotherapy.
- Authors
Lewandowski, Robert; Memon, Khairuddin; Mulcahy, Mary; Hickey, Ryan; Marshall, Karen; Williams, Melissa; Salzig, Krystina; Gates, Vanessa; Atassi, Bassel; Vouche, Michael; Atassi, Rohi; Desai, Kush; Hohlastos, Elias; Sato, Kent; Habib, Ali; Kircher, Sheetal; Newman, Steven; Nimeiri, Halla; Benson, Al; Salem, Riad
- Abstract
Purpose: The aim of this study was to analyze the safety, treatment characteristics and survival outcomes of Yttrium-90 (Y90) radioembolization for unresectable colorectal carcinoma (CRC) liver metastases refractory to standard of care therapy. Methods: A total of 214 patients with CRC metastases were treated with Y90 radioembolization over 12 years. Toxicity was assessed using National Cancer Institute common terminology criteria. Overall survival was analyzed from date of diagnosis of primary cancer, hepatic metastases and from the first Y90. Uni/multivariate analyses were performed. Substratification by era of chemotherapeutics was performed. Results: Most patients were male (60 %) and <65 years old (61 %). Of them, 98 % had been exposed to chemotherapy. Grade 3 lymphocyte, bilirubin, albumin, ALP and AST toxicities were observed in 39 %, 11 %, 10 %, 8 % and 4 % of patients, respectively. Grade 4 lymphocyte and ALP toxicities were observed in 5 % and 3 % of patients, respectively. Median overall survival was 43.0, 34.6, and 10.6 months from date of diagnosis of primary cancer, hepatic metastases and first Y90, respectively. Survival was significantly longer in patients: (1) who received ≤2 cytotoxic drugs ( n = 104) than those who received 3 ( n = 110) (15.2 vs. 7.5 months, p = 0.0001); and (2) who received no biologic agents ( n = 52) compared with those that did ( n = 162) (18.6 vs. 9.4 months, p = 0.0001). Multivariate analyses identified ≤2 cytotoxic agents, no exposure to biologics, ECOG 0, tumor burden <25 %, lack of extrahepatic disease and albumin >3 g/dL as independent predictors of survival. Conclusion: In this largest metastatic CRC series published to date, Y90 radioembolization was found to be safe; survival varied by prior therapy. Further studies are required to further refine the role of Y90 in metastatic CRC.
- Subjects
RADIOEMBOLIZATION; COLON cancer patients; COLON cancer treatment; CANCER chemotherapy; CANCER-related mortality
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2014, Vol 41, Issue 10, p1861
- ISSN
1619-7070
- Publication type
Article
- DOI
10.1007/s00259-014-2799-2