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Erschienen in: European Radiology 1/2017

08.04.2016 | Interventional

Robust evidence for long-term survival with 90Y radioembolization in chemorefractory liver-predominant metastatic colorectal cancer

verfasst von: T. F. Jakobs, K. J. Paprottka, F. Raeßler, F. Strobl, S. Lehner, H. Ilhan, C. G. Trumm, W. P. Fendler, W. Sommer, P. M. Paprottka

Erschienen in: European Radiology | Ausgabe 1/2017

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Abstract

Objectives

Our aim was to provide further evidence for the efficacy/safety of radioembolization using yttrium-90-resin microspheres for unresectable chemorefractory liver metastases from colorectal cancer (mCRC).

Methods

We followed 104 consecutively treated patients until death. Overall survival (OS) was calculated from the day of the first radioembolization procedure. Response was defined by changes in tumour volume as defined by Response Evaluation Criteria in Solid Tumours (RECIST) v1.0 and/or a ≥30 % reduction in serum carcinoembryonic antigen (CEA) at 3 months.

Results

Survival varied between 23 months in patients who had a complete response to prior chemotherapy and 13 months in patients with a partial response or stable disease. Median OS also significantly improved (from 5.8 months to 17.1 months) if response durability to radioembolization extended beyond 6 months. Patients with a positive trend in CEA serum levels (≥30 % reduction) at 3 months post-radioembolization also had a survival advantage compared with those who did not: 15.0 vs 6.7 months. Radioembolization was well tolerated. Grade 3 increases in bilirubin were reported in 5.0 % of patients at 3 months postprocedure.

Conclusions

After multiple chemotherapies, many patients still have a good performance status and are eligible for radioembolization. This single procedure can achieve meaningful survivals and is generally well tolerated.

Key Points

After multiple chemotherapies, many patients are still eligible for radioembolization (RE).
RE can achieve meaningful survival in patients with chemorefractory liver-predominant metastatic colorectal cancer (mCRC).
Tumour responsiveness to prior systemic treatments is a significant determinant of overall survival (OS) after RE.
Radioembolization in patients with a good performance status is generally well tolerated.
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Metadaten
Titel
Robust evidence for long-term survival with 90Y radioembolization in chemorefractory liver-predominant metastatic colorectal cancer
verfasst von
T. F. Jakobs
K. J. Paprottka
F. Raeßler
F. Strobl
S. Lehner
H. Ilhan
C. G. Trumm
W. P. Fendler
W. Sommer
P. M. Paprottka
Publikationsdatum
08.04.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 1/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4345-z

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