Selective transarterial radioembolisation of unresectable liver-dominant colorectal cancer refractory to chemotherapy

Rita Golfieri, Cristina Mosconi, Emanuela Giampalma, Alberta Cappelli, Maria Cristina Galaverni, Cinzia Pettinato, Matteo Renzulli, Fabio Monari, Renzo Mazzarotto, Carmine Pinto, Bruna Angelelli

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The target lesion response (according to the Choi criteria), safety and survival following selective or superselective transarterial radioembolisation using yttrium-90-resin microspheres (90Y-RE) were evaluated in patients with unresectable, chemotherapy-refractory colorectal cancer liver metastases (mCRC). Materials and methods: A prospective case series evaluated 52 consecutive patients with mCRC who were treated at a single centre following a median of 2 lines of chemotherapy. Results: Nearly half (46.2 %) of the 52 patients had a prior resection of the liver. At baseline, mCRC was limited to the liver (in 56.9 %), liver plus extra-hepatic metastases (23.5 %) or liver plus lung micro-nodules (19.6 %). Disease control rates of target lesions (partial response plus stable disease) at 3 and 6 months post-90Y-RE were 59 and 29 %, respectively. Target lesions were sufficiently downsized in two patients for hepatic resection and in one patient for radiofrequency ablation. Median Kaplan–Meier survival was 11.0 months (95 % confidence interval: 8.0–14.0 months) overall and 12.0 months in liver-only disease (±lung micro-nodules). Determinants of prolonged survival were response at 3 months (P = 0.046), ≤5 liver nodules (P = 0.004), single-liver-lobe involvement (P = 0.037), tumour-to-whole liver ratio 90Y-RE were grade 1 90Y-RE-induced liver disease (n = 1), grade 2 and 3 gastric ulcers (n = 2). Conclusion: These results confirm the effectiveness and safety of selective 90Y-RE in patients with chemotherapy-refractory mCRC, showing 90Y-RE’s potential as a bridging therapy to subsequent resection even in this end-stage population.

Original languageEnglish
Pages (from-to)767-776
Number of pages10
JournalRadiologia Medica
Volume120
Issue number8
DOIs
Publication statusPublished - Aug 24 2015

Keywords

  • Colorectal cancer
  • Liver metastases
  • Radioembolization
  • Selective internal radiation therapy
  • SIRT
  • Yttrium-90

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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