90Y glass microspheres for the treatment of unresectable metastatic liver disease from chemotherapy-refractory gastrointestinal cancers: A pilot study

被引：0

作者：

Fidelman N. ^{[1
]}

Kerlan Jr. R.K. ^{[1
]}

Hawkins R.A. ^{[1
]}

Taylor A.G. ^{[1
]}

Kohi M.P. ^{[1
]}

Kolli K.P. ^{[1
]}

Bergsland E.K. ^{[2
]}

Kelley R.K. ^{[2
]}

Ko A.H. ^{[2
]}

Korn W.M. ^{[2
]}

McWhirter R.M. ^{[2
]}

Luan J. ^{[2
]}

Venook A.P. ^{[2
]}

机构：

[1] Department of Radiology, University of California San Francisco, San Francisco, CA 94143

[2] Department of Medicine, University of California San Francisco, San Francisco, CA

来源：

Journal of Gastrointestinal Cancer | 2014年 / 45卷 / 2期

关键词：

Liver; Metastases; Radioembolization; Yttrium-90 glass microspheres;

D O I：

10.1007/s12029-013-9566-7

中图分类号：

学科分类号：

摘要：

Purpose: This prospective pilot single-institution study was undertaken to document the feasibility, safety, and efficacy of treatment of liver-dominant metastatic gastrointestinal cancer using 90Y glass microspheres. Methods: Between June 2010 and November 2012, 30 adult patients (22 men, eight women; median age 61 years) with metastatic chemotherapy-refractory unresectable colorectal (n=15), neuroendocrine (n=9), intrahepatic cholangiocarcinoma (n=3), pancreas (n=2), and esophageal (n=1) carcinomas underwent 45 lobar or segmental administrations of 90Y glass microspheres. Data regarding clinical and laboratory adverse events (AE) were collected prospectively for 6 months after each treatment. Radiographic responses were evaluated using Response Evaluation Criteria in Solid Tumors, version 1.1. Time to maximum response, response duration, progression-free survival (hepatic and extrahepatic), and overall survival were measured. Results: Median target dose and activity were 111.6 Gy and 2.5 GBq per treatment session, respectively. All but three clinical AE were grade 1 or 2 in severity. Serious AE included an unplanned hospital admission for carcinoid crisis, grade 3 vomiting, and grade 4 gastric ulcer. Patients with colorectal cancer had hepatic objective response rate (ORR) of 27 % and a disease control rate (DCR) of 73 %. Median progression-free and overall survival were 1.0 and 4.9 months, respectively. Patients with neuroendocrine tumors had hepatic ORR and DCR of 78 % and 100 %, respectively. Median progression-free survival was 18.5 months for this cohort. Conclusions: Y glass microspheres device has a favorable safety profile and achieved prolonged disease control of hepatic tumor burden in a subset of patients, including all patients enrolled in the neuroendocrine cohort. © 2014 Springer Science+Business Media.

引用

页码：168 / 180

页数：12

共 36 条

[1]

Pawlik T.M., Choti M.A., Surgical therapy for colorectal metastases to the liver, J Gastrointest Surg, 11, pp. 1057-1077, (2007)

[2]

Al-Asfoor A., Feorowicz Z., Lodge M., Resection versus no intervention or other surgical interventions for colorectal cancer liver metastases, Cochrane Database Syst Rev, 16, (2008)

[3]

Llovet J.M., Treatment of hepatocellular cancer, Curr Treat Options Gastroenterol, 7, pp. 431-441, (2004)

[4]

Ziessman H.A., Thrall J.H., Gyves J.W., Quantitative hepatic arterial perfusion scintigraphy and starch micropheres in cancer chemotherapy, Journal of Nuclear Medicine, 24, 10, pp. 871-875, (1983)

[5]

King J., Quinn R., Glenn D.M., Janssen J., Tong D., Liaw W., Et al., Radioembolization with selective internal radiation microspheres for neuroendocrine liver metastases, Cancer, 113, pp. 921-929, (2008)

[6]

Jakobs T.F., Hoffmann R.T., Dehm K., Trumm C., Stemmler H.J., Tatsch K., Et al., Hepatic Yttrium-90 radioembolization of chemotherapy-refractory colorectal cancer liver metastases, J Vasc Interv Radiol, 19, pp. 1187-1195, (2008)

[7]

Jakobs T.F., Hoffmann R.T., Fischer T., Stemmler H.J., Tatsch K., La Fougere C., Et al., Radioembolization in patients with hepatic metastases from breast cancer, J Vasc Interv Radiol, 19, pp. 683-690, (2008)

[8]

Sato K.T., Lewandowski R.J., Mulcahy M.F., Atassi B., Ryu R.K., Gates V.L., Et al., Unresectable chemorefractory liver metastases: Radioembolization with <sup>90</sup>Y microspheres - safety, efficacy, and survival, Radiology, 247, pp. 507-515, (2008)

[9]

Rhee T.K., Lewandowski R.J., Liu D.M., Mulcahy M.F., Takahashi G., Hansen P.D., Et al., <sup>90</sup>Y radioembolization for metastatic neuroendocrine liver tumors: Preliminary results from a multi-institutional experience, Ann Surg, 247, pp. 1029-1035, (2008)

[10]

Kennedy A.S., Coldwell D., Nutting C., Murthy R., Wertman Jr. D.E., Loehr S.P., Et al., Resin 90Y-microsphere brachytherapy for unresectable colorectal liver metastases: Modern USA experience, Int J Radiat Oncol Biol Phys, 65, pp. 412-425, (2006)

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