Is Yttrium-90 Radioembolization a Viable Treatment Option for Unresectable, Chemorefractory Colorectal Cancer Liver Metastases? A Large Single-Center Experience of 302 Patients

被引:55
作者
Saxena, Akshat [1 ,2 ]
Meteling, Baerbel [1 ]
Kapoor, Jada [2 ]
Golani, Sanjeev [1 ]
Morris, David L. [2 ]
Bester, Lourens [1 ]
机构
[1] St Vincents Hosp Sydney, Dept Intervent Radiol, Darlinghurst, NSW, Australia
[2] St George Hosp, UNSW Dept Surg, Kogarah, NSW, Australia
关键词
HEPATIC ARTERIAL INFUSION; PHASE-II; RESIN MICROSPHERES; PLUS FLUOROURACIL; IRINOTECAN; CHEMOTHERAPY; LEUCOVORIN; BEVACIZUMAB; THERAPY; TRIAL;
D O I
10.1245/s10434-014-4164-x
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Introduction. We report the largest series to date on the safety and efficacy of yttrium-90 (90Y) radioembolization for the treatment of unresectable, chemorefractory colorectal cancer liver metastases (CRCLM). Methods. A total of 302 patients underwent resin-based 90Y radioembolization for unresectable, chemorefractory CRCLM between 2006 and 2013 in Sydney, Australia. All patients were followed up with imaging studies at regular intervals until death. Radiologic response was evaluated with the response criteria in solid tumors criteria. Clinical toxicities were prospectively recorded. Survival was calculated by the Kaplan-Meier method, and potential prognostic variables were identified on univariate and multivariate analysis. Results. Median follow-up in the complete cohort was 7.2 months (range 0.2-72.8), and the median survival after 90Y radioembolization was 10.5 months with a 24-month survival of 21 %. On imaging follow-up of 293 patients who were followed up beyond 2 months, complete response to treatment was observed in 2 patients (1 %), partial response in 111 (38 %), stable disease in 96 (33 %), and progressive disease in 84 (29 %). Four factors were independently associated with a poorer prognosis: extensive tumor volume, number of previous lines of chemotherapy, poor radiological response to treatment, and low preoperative hemoglobin. One hundred fifteen (38 %) developed clinical toxicity after treatment; most complications were minor (grade I/II) and resolved without active intervention. Conclusions. 90Y radioembolization is a safe and effective treatment for unresectable, chemorefractory CRCLM.
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收藏
页码:794 / 802
页数:9
相关论文
共 38 条
  • [1] Adam R, 2004, ANN SURG, V240, P644, DOI 10.1097/01.sla.0000141198.92114.16
  • [2] Chemoembolization of Colorectal Liver Metastases With Cisplatin, Doxorubicin, Mitomycin C, Ethiodol, and Polyvinyl Alcohol
    Albert, Marissa
    Kiefer, Matthew V.
    Sun, Weijing
    Haller, Daniel
    Fraker, Douglas L.
    Tuite, Catherine M.
    Stavropoulos, S. William
    Mondschein, Jeffrey I.
    Soulen, Michael C.
    [J]. CANCER, 2011, 117 (02) : 343 - 352
  • [3] Wild-type KRAS is required for panitumumab efficacy in patients with metastatic colorectal cancer
    Amado, Rafael G.
    Wolf, Michael
    Peeters, Marc
    Van Cutsem, Eric
    Siena, Salvatore
    Freeman, Daniel J.
    Juan, Todd
    Sikorski, Robert
    Suggs, Sid
    Radinsky, Robert
    Patterson, Scott D.
    Chang, David D.
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (10) : 1626 - 1634
  • [4] [Anonymous], 2013, GLOBOCAN 2012 V1 0 C
  • [5] [Anonymous], ANN SURG
  • [6] [Anonymous], ANN SURG
  • [7] Beppu T, 2010, ANTICANCER RES, V30, P1015
  • [8] Reduction of arteriohepatovenous shunting by temporary balloon occlusion in patients undergoing radioembolizationL
    Bester, Lourens
    Salem, Riad
    [J]. JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2007, 18 (10) : 1310 - 1314
  • [9] Phase II Study of Irinotecan and Cetuximab Given Every 2 Weeks as Second-Line Therapy for Advanced Colorectal Cancer
    Carneiro, Benedito A.
    Ramanathan, Ramesh K.
    Fakih, Marwan G.
    Krishnamurthi, Smitha S.
    Lembersky, Barry C.
    Stoller, Ronald G.
    Lancaster, Stewart L.
    Pinkerton, Richard A.
    Crandall, Theodore L.
    Schmotzer, Amy R.
    Potter, Douglas M.
    Bahary, Nathan
    [J]. CLINICAL COLORECTAL CANCER, 2012, 11 (01) : 53 - 59
  • [10] Phase II multicenter trial of bevacizumab plus fluorouracil and leucovorin in patients with advanced refractory colorectal cancer: An NCI Treatment Referral Center trial TRC-0301
    Chen, Helen X.
    Mooney, Margaret
    Boron, Matthew
    Vena, Don
    Mosby, Kimberly
    Grochow, Louise
    Jaffe, Carl
    Rubinstein, Lawrence
    Zwiebel, James
    Kaplan, Richard S.
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2006, 24 (21) : 3354 - 3360