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Title: | Yttrium-90 radioembolization for the treatment of chemorefractory colorectal liver metastases: Technical results, clinical outcome and factors potentially influencing survival | 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 |
Issue Date: | 2016 | Publisher: | TAYLOR & FRANCIS LTD | Source: | ACTA ONCOLOGICA, 55 (4), p. 486-495 | 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 (Y-90) 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 Y-90 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 Y-90 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: Y-90 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. | Notes: | [Maleux, Geert; Heye, Sam; Vanbeckevoort, Dirk; Vandecaveye, Vincent] Katholieke Univ Leuven, Dept Imaging & Pathol, Univ Hosp Leuven, Dept Radiol, Louvain, Belgium. [Deroose, Christophe] Univ Hosp Leuven, Dept Nucl Med, B-3000 Louvain, Belgium. [Laenen, Annouschka] Katholieke Univ Leuven, Interuniv Ctr Biostat & Stat Bioinformat, Louvain, Belgium. [Laenen, Annouschka] Univ Hasselt, Hasselt, Belgium. [Verslype, Chris; Prenen, Hans] Univ Hosp Leuven, Dept Gastroenterol, B-3000 Louvain, Belgium. [Heye, Sam] Univ Hosp Leuven, Dept Radiat Oncol, B-3000 Louvain, Belgium. [De Hertogh, Gert; Sagaert, Xavier] Univ Hosp Leuven, Dept Pathol, B-3000 Louvain, Belgium. [Topal, Baki; Aerts, Raymond] Univ Hosp Leuven, Dept Abdominal Surg, B-3000 Louvain, Belgium. | Document URI: | http://hdl.handle.net/1942/21805 | ISSN: | 0284-186X | e-ISSN: | 1651-226X | DOI: | 10.3109/0284186X.2015.1101151 | ISI #: | 000372125400014 | Rights: | © 2015 Taylor & Francis | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2017 |
Appears in Collections: | Research publications |
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10.3109@0284186X.2015.1101151.pdf Restricted Access | Published version | 1.27 MB | Adobe PDF | View/Open Request a copy |
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