Yttrium-90 radioembolization for the treatment of chemorefractory colorectal liver metastases: Technical results, clinical outcome and factors potentially influencing survival. (2nd April 2016)

• Record Type: Journal Article
• Authors: Maleux, Geert; Deroose, Christophe; Laenen, Annouschka; Verslype, Chris; Heye, Sam; Haustermans, Karin; De Hertogh, Gert; Sagaert, Xavier; Topal, Baki; Aerts, Raymond; Prenen, Hans; Vanbeckevoort, Dirk; Vandecaveye, Vincent; Van Cutsem, Eric
• Is Part Of: Acta oncologica. Volume 55:Number 4(2016)
• Page Start: 486
• Page End: 495
• Publication Date: 2016-04-02
• Subjects: Oncology -- Periodicals; Cancer -- Treatment -- Periodicals; 616.992
• DOI: 10.3109/0284186X.2015.1101151
• Languages: English
• ISSNs: 0284-186X

Abstract

Abstract: Background : The purpose of this study was to retrospectively assess the technical and clinical outcomes, overall survival and prognostic factors for prolonged survival after yttrium-90 ( 90 Y) radioembolization as a salvage therapy for patients with chemorefractory liver-only or liver-dominant colorectal metastases. Material and methods : From January 2005 to January 2014, all the patients selected for 90 Y radioembolization to treat chemorefractory colorectal liver metastases were identified. Demographic, laboratory, imaging and dosimetry data were collected. Post-treatment technical and clinical outcomes were analyzed as well as overall survival; finally several factors potentially influencing survival were analyzed. Results : In total 88 patients were selected for angiographic workup; 71 patients (81%) finally underwent catheter-directed 90 Y microsphere infusion into the hepatic artery 25 days (standard deviation 13 days) after angiographic workup. Median infused activity was 1809 MBq; 30-day toxicity included: fatigue ( n = 39; 55%), abdominal discomfort ( n = 33; 47%), nausea ( n = 5; 7%), fever ( n = 14; 20%), diarrhea ( n = 6; 9%), liver function abnormalities and elevated bilirubin (transient) ( n = 3; 4%). Gastric ulcer was found in five patients (7%). A late complication was radioembolization-induced portal hypertension (REIPH) in three patients (4%). Median time to progression in the liver was 4.4 months. Estimated survival at six and 12 months was 65% and 30%, respectively, with a 50% estimated survival after 8.0 months in this group of chemorefractory patients. Prognostic factors for worse survival were high preprocedural bilirubin, alkaline phosphatase and tumor volume levels. Conclusion : 90 Y microsphere radioembolization for chemorefractory colorectal liver metastases has an acceptable safety profile with a 50% estimated survival after 8.0 months. Pretreatment high bilirubin, alkaline phosphatase and tumor volume levels were associated with early death.