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Yttrium-90 radioembolization as salvage therapy for colorectal cancer with liver metastases.

Abstract：

BACKGROUND:Few patients with metastatic colorectal cancer (mCRC) are candidates for resection of their hepatic disease. Yttrium-90 ((90)Y) radioembolization has promise in the treatment of unresectable mCRC. We conducted a retrospective study to assess the efficacy in patients with refractory mCRC who underwent (90)Y radioembolization. MATERIALS AND METHODS:Patients with unresectable mCRC with liver metastases treated at The Ohio State University were included in this analysis. Demographic data, carcinoembryonic antigen (CEA) values, observed toxicities, and information on prior therapies were collected. Response was assessed by RECIST (Response Evaluation Criteria in Solid Tumors) 1.1 criteria. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method. RESULTS:Twenty-four patients (median age, 63 years) were included. Of the patients, 54% had extrahepatic disease; 67% had bilobar involvement. The patients had received a median of 3 prior therapies. No objective responses were observed. Five patients had a CEA response. Median PFS and OS were 3.9 months (95% CI, 2.4-4.8 months) and 8.9 months (95% CI, 4.2-16.7 months), respectively. Patients older than 65 years had improved PFS (4.6 vs. 2.4 months) and OS (14 vs. 5.5 months) vs. younger patients, likely due to receipt of (90)Y treatment earlier in their disease course. The presence of extrahepatic disease and the absence of CEA response appeared negatively predictive of efficacy. Toxicities were expected and manageable. CONCLUSION:(90)Y radioembolization is active in select patients with refractory mCRC and with liver metastases, and is safe and well tolerated in the elderly. In patients with extensive extrahepatic disease, (90)Y should be used in combination with chemotherapy. CEA may be a predictor of efficacy.

journal_name

Clin Colorectal Cancer

journal_title

Clinical colorectal cancer

authors

Martin LK,Cucci A,Wei L,Rose J,Blazer M,Schmidt C,Khabiri H,Bloomston M,Bekaii-Saab T

doi

10.1016/j.clcc.2011.12.002

subject

Has Abstract

pub_date

2012-09-01 00:00:00

pages

195-9

issue

eissn

1533-0028

issn

1938-0674

pii

S1533-0028(11)00171-X

journal_volume

pub_type

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Yttrium-90 radioembolization as salvage therapy for colorectal cancer with liver metastases.