90Y Radioembolization of Colorectal Hepatic Metastases Using Glass Microspheres: Safety and Survival Outcomes from a 531-Patient Multicenter Study.
UNLABELLED
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.
['Hickey|Ryan|R|', 'Lewandowski|Robert J|RJ|', 'Prudhomme|Totianna|T|', 'Ehrenwald|Eduardo|E|', 'Baigorri|Brian|B|', 'Critchfield|Jeffrey|J|', 'Kallini|Joseph|J|', 'Gabr|Ahmed|A|', 'Gorodetski|Boris|B|', 'Geschwind|Jean-Francois|JF|', 'Abbott|Andrea|A|', 'Shridhar|Ravi|R|', 'White|Sarah B|SB|', 'Rilling|William S|WS|', 'Boyer|Brendan|B|', 'Kauffman|Shannon|S|', 'Kwan|Sharon|S|', 'Padia|Siddarth A|SA|', 'Gates|Vanessa L|VL|', 'Mulcahy|Mary|M|', 'Kircher|Sheetal|S|', 'Nimeiri|Halla|H|', 'Benson|Al B|AB|', 'Salem|Riad|R|']
D000368:Aged D015179:Colorectal Neoplasms D004621:Embolization, Therapeutic D005260:Female D005898:Glass D006801:Humans D008113:Liver Neoplasms D008297:Male D008863:Microspheres D008875:Middle Aged D015999:Multivariate Analysis D011874:Radiometry D012189:Retrospective Studies D012449:Safety D016019:Survival Analysis D016896:Treatment Outcome D015021:Yttrium Radioisotopes
90Y radioembolization survival colorectal metastases