PURPOSE: This study was designed to evaluate overall survival after radioembolization or best supportive care (BSC) in patients with chemotherapy-refractory liver-dominant metastatic colorectal cancer (mCRC). METHODS: This was a matched-pair comparison of patients who received radioembolization plus BSC or BSC alone for extensive liver disease. Twenty-nine patients who received radioembolization were retrospectively matched with a contemporary cohort of >500 patients who received BSC from 3 centers in Germany. Using clinical databases, patients were initially matched for prior treatments and tumor burden and then 29 patients were consecutively identified with two or more of four matching criteria: synchronous/metachronous metastases, tumor burden, increased ALP, and/or CEA >200 U/ml. Survival was calculated from date of progression before radioembolization or BSC by using Kaplan-Meier analysis. RESULTS: Of 29 patients in each study arm, 16 pairs (55.2%) matched for all four criteria, and 11 pairs (37.9%) matched three criteria. Patients in both groups had a similar performance status (Karnofsky index, median 80% [range, 60-100%]). Compared with BSC alone, radioembolization prolonged survival (median, 8.3 vs. 3.5 months; P < 0.001) with a hazard ratio of 0.3 (95% confidence interval, 0.16-0.55; P < 0.001) in a multivariate Cox proportional hazard model. Treatment-related adverse events following radioembolization included: grade 1-2 fatigue (n = 20, 69%), grade 1 abdominal pain/nausea (n = 14, 48.3%), and grade 2 gastrointestinal ulceration (n = 3, 10.3%). Three cases of grade 3 radiation-induced liver disease were symptomatically managed. CONCLUSIONS: Radioembolization offers a promising addition to BSC in treatment-refractory patients for whom there are limited options. Survival was prolonged and adverse events were generally mild-to-moderate in nature and manageable.
PURPOSE: This study was designed to evaluate overall survival after radioembolization or best supportive care (BSC) in patients with chemotherapy-refractory liver-dominant metastatic colorectal cancer (mCRC). METHODS: This was a matched-pair comparison of patients who received radioembolization plus BSC or BSC alone for extensive liver disease. Twenty-nine patients who received radioembolization were retrospectively matched with a contemporary cohort of >500 patients who received BSC from 3 centers in Germany. Using clinical databases, patients were initially matched for prior treatments and tumor burden and then 29 patients were consecutively identified with two or more of four matching criteria: synchronous/metachronous metastases, tumor burden, increased ALP, and/or CEA >200 U/ml. Survival was calculated from date of progression before radioembolization or BSC by using Kaplan-Meier analysis. RESULTS: Of 29 patients in each study arm, 16 pairs (55.2%) matched for all four criteria, and 11 pairs (37.9%) matched three criteria. Patients in both groups had a similar performance status (Karnofsky index, median 80% [range, 60-100%]). Compared with BSC alone, radioembolization prolonged survival (median, 8.3 vs. 3.5 months; P < 0.001) with a hazard ratio of 0.3 (95% confidence interval, 0.16-0.55; P < 0.001) in a multivariate Cox proportional hazard model. Treatment-related adverse events following radioembolization included: grade 1-2 fatigue (n = 20, 69%), grade 1 abdominal pain/nausea (n = 14, 48.3%), and grade 2 gastrointestinal ulceration (n = 3, 10.3%). Three cases of grade 3 radiation-induced liver disease were symptomatically managed. CONCLUSIONS: Radioembolization offers a promising addition to BSC in treatment-refractory patients for whom there are limited options. Survival was prolonged and adverse events were generally mild-to-moderate in nature and manageable.
Authors: Constantinos T Sofocleous; Elena G Violari; Vlasios S Sotirchos; Waleed Shady; Mithat Gonen; Neeta Pandit-Taskar; Elena N Petre; Lynn A Brody; William Alago; Richard K Do; Michael I D'Angelica; Joseph R Osborne; Neil H Segal; Jorge A Carrasquillo; Nancy E Kemeny Journal: Clin Colorectal Cancer Date: 2015-06-27 Impact factor: 4.481
Authors: Andrew S Kennedy; David Ball; Steven J Cohen; Michael Cohn; Douglas M Coldwell; Alain Drooz; Eduardo Ehrenwald; Samir Kanani; Steven C Rose; Charles W Nutting; Fred M Moeslein; Michael A Savin; Sabine Schirm; Samuel G Putnam; Navesh K Sharma; Eric A Wang Journal: J Gastrointest Oncol Date: 2015-04
Authors: Tatjana Gruber-Rouh; Christian Marko; Axel Thalhammer; Nour-Eldin Nour-Eldin; Marcel Langenbach; Martin Beeres; Nagy N Naguib; Stephan Zangos; Thomas J Vogl Journal: Br J Radiol Date: 2016-05-26 Impact factor: 3.039
Authors: John L Nosher; Inaya Ahmed; Akshar N Patel; Vyacheslav Gendel; Philip G Murillo; Rebecca Moss; Salma K Jabbour Journal: J Gastrointest Oncol Date: 2015-04
Authors: Bertrand Janne d'Othée; Constantinos T Sofocleous; Nader Hanna; Robert J Lewandowski; Michael C Soulen; Jean-Nicolas Vauthey; Steven J Cohen; Alan P Venook; Matthew S Johnson; Andrew S Kennedy; Ravi Murthy; Jean-Francois Geschwind; Stephen T Kee Journal: J Vasc Interv Radiol Date: 2012-02 Impact factor: 3.464