Format

Send to

Choose Destination
See comment in PubMed Commons below
J Nucl Med. 2016 May;57(5):665-71. doi: 10.2967/jnumed.115.166082. Epub 2015 Dec 3.

90Y Radioembolization of Colorectal Hepatic Metastases Using Glass Microspheres: Safety and Survival Outcomes from a 531-Patient Multicenter Study.

Author information

1
Section of Interventional Radiology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, Chicago, Illinois.
2
Department of Interventional Radiology, Abbott Northwestern Hospital, Minneapolis, Minnesota.
3
Department of Radiology, Detroit Medical Center, Wayne State University, Detroit, Michigan.
4
Interventional Radiology Center, Johns Hopkins Hospital, Baltimore, Maryland.
5
Department of Surgery, Moffitt Cancer Center, Tampa, Florida.
6
Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida.
7
Division of Vascular/Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin.
8
Department of Radiology, Miami Valley Hospital, Dayton, Ohio.
9
Section of Interventional Radiology, Department of Radiology, University of Washington, Seattle, Washington; and.
10
Division of Hematology and Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois.
11
Section of Interventional Radiology, Department of Radiology, Robert H. Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, Chicago, Illinois Division of Hematology and Oncology, Department of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois r-salem@northwestern.edu.

Abstract

Hepatic metastases of colorectal carcinoma are a leading cause of cancer-related mortality. Most colorectal liver metastases become refractory to chemotherapy and biologic agents, at which point the median overall survival declines to 4-5 mo. Radioembolization with (90)Y has been used in the salvage setting with favorable outcomes. This study reports the survival and safety outcomes of 531 patients treated with glass-based (90)Y microspheres at 8 institutions, making it the largest (90)Y study for patients with colorectal liver metastases.

METHODS:

Data were retrospectively compiled from 8 institutions for all (90)Y glass microsphere treatments for colorectal liver metastases. Exposure to chemotherapeutic or biologic agents, prior liver therapies, biochemical parameters before and after treatment, radiation dosimetry, and complications were recorded. Uni- and multivariate analyses for predictors of survival were performed. Survival outcomes and clinical or biochemical adverse events were recorded.

RESULTS:

In total, 531 patients received (90)Y radioembolization for colorectal liver metastases. The most common clinical adverse events were fatigue (55%), abdominal pain (34%), and nausea (19%). Grade 3 or 4 hyperbilirubinemia occurred in 13% of patients at any time. The median overall survival from the first (90)Y treatment was 10.6 mo (95% confidence interval, 8.8-12.4). Performance status, no more than 25% tumor burden, no extrahepatic metastases, albumin greater than 3 g/dL, and receipt of no more than 2 chemotherapeutic agents independently predicted better survival outcomes.

CONCLUSION:

This multiinstitutional review of a large cohort of patients with colorectal liver metastases treated with (90)Y radioembolization using glass microspheres has demonstrated promising survival outcomes with low toxicity and low side effects. The outcomes were reproducible and consistent with prior reports of radioembolization.

KEYWORDS:

90Y; colorectal metastases; radioembolization; survival

PMID:
26635340
DOI:
10.2967/jnumed.115.166082
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Support Center