Radioembolization as a salvage therapy for heavily pretreated patients with colorectal cancer liver metastases: Factors that affect outcomes Journal Article

Authors: Sofocleous, C. T.; Violari, E. G.; Sotirchos, V. S.; Shady, W.; Gonen, M.; Pandit-Taskar, N.; Petre, E. N.; Brody, L. A.; Alago, W.; Do, R. K.; D'Angelica, M. I.; Osborne, J. R.; Segal, N. H.; Carrasquillo, J. A.; Kemeny, N. E.
Article Title: Radioembolization as a salvage therapy for heavily pretreated patients with colorectal cancer liver metastases: Factors that affect outcomes
Abstract: Background In this study we assessed the efficacy and factors that affect outcomes of radioembolization (RE) using yttrium-90 resin microspheres in patients with unresectable and chemorefractory colorectal cancer liver metastases (CLM). Patients and Methods After an institutional review board waiver of approval, a review of a Health Insurance Portability and Accountability Act-registered, prospectively created and maintained database was performed. Data on patient demographic and disease characteristics, RE treatment parameters, and additional treatments were evaluated for significance in predicting overall survival (OS) and liver progression-free survival (LPFS). Complications were evaluated according to the National Cancer Institute Common Terminology Criteria for adverse events. Results From September 2009 to September 2013, 53 patients underwent RE at a median of 35 months after CLM diagnosis. Median OS was 12.7 months. Multivariate analysis showed that carcinoembryonic antigen levels at the time of RE ≥ 90 ng/mL (P =.004) and microscopic lymphovascular invasion of the primary (P =.002) were independent predictors of decreased OS. Median LPFS was 4.7 months. At 4 to 8 and 12 to 16 weeks after RE, most patients (80% and 61%, respectively) according to Response Evaluation Criteria in Solid Tumors (RECIST) had stable disease; additional evaluation using PET Response Criteria in Solid Tumors (PERCIST) led to reclassification in 77% of these cases (response or progression). No deaths were noted within the first 30 days. Within the first 90 days after RE, 4 patients (8%) developed liver failure and 5 patients (9%) died, all with evidence of disease progression. Conclusion RE in the salvage setting was well-tolerated, and permitted the administration of additional therapies and led to a median OS of 12.7 months. Evaluation using PERCIST was more likely than RECIST to document response or progression compared with the baseline assessment before RE. © 2015 Elsevier Inc.
Keywords: hepatic malignancy; yttrium-90; arterially directed therapies; sirt; selective internal radiation therapy
Journal Title: Clinical Colorectal Cancer
Volume: 14
Issue: 4
ISSN: 1533-0028
Publisher: Elsevier Inc.  
Date Published: 2015-12-01
Start Page: 296
End Page: 305
Language: English
DOI: 10.1016/j.clcc.2015.06.003
PROVIDER: scopus
PUBMED: 26277696
PMCID: PMC5058358
Notes: Export Date: 2 December 2015 -- Source: Scopus
Citation Impact
MSK Authors
  1. William Alago
    25 Alago
  2. Joseph R Osborne
    60 Osborne
  3. Neil Howard Segal
    146 Segal
  4. Mithat Gonen
    785 Gonen
  5. Kinh Gian Do
    154 Do
  6. Lynn Brody
    100 Brody
  7. Elena Nadia Petre
    58 Petre
  8. Nancy Kemeny
    439 Kemeny
  9. Waleed   Shady
    10 Shady