Faculty Collaboration Database

90Y Radioembolization of Colorectal Hepatic Metastases Using Glass Microspheres: Safety and Survival Outcomes from a 531-Patient Multicenter Study. J Nucl Med 2016 May;57(5):665-71

Date

12/05/2015

Pubmed ID

26635340

DOI

10.2967/jnumed.115.166082

Scopus ID

2-s2.0-84966775474 (requires institutional sign-in at Scopus site)   75 Citations

Abstract

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.

Author List

Hickey R, Lewandowski RJ, Prudhomme T, Ehrenwald E, Baigorri B, Critchfield J, Kallini J, Gabr A, Gorodetski B, Geschwind JF, Abbott A, Shridhar R, White SB, Rilling WS, Boyer B, Kauffman S, Kwan S, Padia SA, Gates VL, Mulcahy M, Kircher S, Nimeiri H, Benson AB, Salem R

Authors

William S. Rilling MD, FSIR Vice Chair, Professor in the Radiology department at Medical College of Wisconsin
Sarah B. White MD, MS, FSIR, FCIRSE Associate Dean, Vice Chair, Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Colorectal Neoplasms
Embolization, Therapeutic
Female
Glass
Humans
Liver Neoplasms
Male
Microspheres
Middle Aged
Multivariate Analysis
Radiometry
Retrospective Studies
Safety
Survival Analysis
Treatment Outcome
Yttrium Radioisotopes