Yttrium-90 radioembolization for the treatment of chemorefractory colorectal liver metastases

http://www.ncbi.nlm.nih.gov/pubmed/26625262

Without the full text, I'm not too aware of the impact. Any medcos like to comment?

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Acta Oncol. 2015 Dec 1:1-10. [Epub ahead of print]
Yttrium-90 radioembolization for the treatment of chemorefractory colorectal liver metastases: Technical results, clinical outcome and factors potentially influencing survival.

Maleux G¹, Deroose C², Laenen A³, Verslype C⁴, Heye S¹, Haustermans K⁵, De Hertogh G⁶, Sagaert X⁶, Topal B⁷, Aerts R⁷, Prenen H⁴, Vanbeckevoort D¹, Vandecaveye V¹, Van Cutsem E⁴.
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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 (⁹⁰Y) 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 ⁹⁰Y 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 ⁹⁰Y 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:

⁹⁰Y 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.