90Y radioembolization of colorectal hepatic metastases using glass microspheres

Safety and survival outcomes from a 531-patient multicenter study

Ryan M Hickey, Robert J Lewandowski, Totianna Prudhomme, Eduardo Ehrenwald, Brian Baigorri, Jeffrey Critchfield, Joseph Kallini, Ahmed Gabr, Boris Gorodetski, Jean Francois Geschwind, Andrea Abbott, Ravi Shridhar, Sarah B. White, William S. Rilling, Brendan Boyer, Shannon Kauffman, Sharon Kwan, Siddarth A. Padia, Vanessa L. Gates, Mary Frances Mulcahy & 4 others Sheetal Mehta Kircher, Halla S Nimeiri, Al B Benson III, Riad Salem

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

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 90Y 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 90Y microspheres at 8 institutions, making it the largest 90Y study for patients with colorectal liver metastases. Methods: Data were retrospectively compiled from 8 institutions for all 90Y 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 90Y 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 90Y 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 90Y 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. 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Original languageEnglish (US)
Pages (from-to)665-671
Number of pages7
JournalJournal of Nuclear Medicine
Volume57
Issue number5
DOIs
StatePublished - May 1 2016

Fingerprint

Eye Protective Devices
Microspheres
Multicenter Studies
Neoplasm Metastasis
Survival
Liver
Glass
Biological Factors
Radiometry
Molecular Imaging
Hyperbilirubinemia
Therapeutics
Tumor Burden
Nausea
Abdominal Pain
Fatigue
Albumins
Colorectal Neoplasms
Multivariate Analysis
Confidence Intervals

Keywords

  • Colorectal metastases
  • Radioembolization
  • Survival
  • Y

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Hickey, Ryan M ; Lewandowski, Robert J ; Prudhomme, Totianna ; Ehrenwald, Eduardo ; Baigorri, Brian ; Critchfield, Jeffrey ; Kallini, Joseph ; Gabr, Ahmed ; Gorodetski, Boris ; Geschwind, Jean Francois ; Abbott, Andrea ; Shridhar, Ravi ; White, Sarah B. ; Rilling, William S. ; Boyer, Brendan ; Kauffman, Shannon ; Kwan, Sharon ; Padia, Siddarth A. ; Gates, Vanessa L. ; Mulcahy, Mary Frances ; Kircher, Sheetal Mehta ; Nimeiri, Halla S ; Benson III, Al B ; Salem, Riad. / 90Y radioembolization of colorectal hepatic metastases using glass microspheres : Safety and survival outcomes from a 531-patient multicenter study. In: Journal of Nuclear Medicine. 2016 ; Vol. 57, No. 5. pp. 665-671.
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title = "90Y radioembolization of colorectal hepatic metastases using glass microspheres: Safety and survival outcomes from a 531-patient multicenter study",
abstract = "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 90Y 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 90Y microspheres at 8 institutions, making it the largest 90Y study for patients with colorectal liver metastases. Methods: Data were retrospectively compiled from 8 institutions for all 90Y 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 90Y 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 90Y 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 90Y 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. 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.",
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author = "Hickey, {Ryan M} and Lewandowski, {Robert J} and Totianna Prudhomme and Eduardo Ehrenwald and Brian Baigorri and Jeffrey Critchfield and Joseph Kallini and Ahmed Gabr and Boris Gorodetski and Geschwind, {Jean Francois} and Andrea Abbott and Ravi Shridhar and White, {Sarah B.} and Rilling, {William S.} and Brendan Boyer and Shannon Kauffman and Sharon Kwan and Padia, {Siddarth A.} and Gates, {Vanessa L.} and Mulcahy, {Mary Frances} and Kircher, {Sheetal Mehta} and Nimeiri, {Halla S} and {Benson III}, {Al B} and Riad Salem",
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Hickey, RM, 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, MF, Kircher, SM, Nimeiri, HS, Benson III, AB & Salem, R 2016, '90Y radioembolization of colorectal hepatic metastases using glass microspheres: Safety and survival outcomes from a 531-patient multicenter study', Journal of Nuclear Medicine, vol. 57, no. 5, pp. 665-671. https://doi.org/10.2967/jnumed.115.166082

90Y radioembolization of colorectal hepatic metastases using glass microspheres : Safety and survival outcomes from a 531-patient multicenter study. / Hickey, Ryan M; Lewandowski, Robert J; Prudhomme, Totianna; Ehrenwald, Eduardo; Baigorri, Brian; Critchfield, Jeffrey; Kallini, Joseph; Gabr, Ahmed; Gorodetski, Boris; Geschwind, Jean Francois; Abbott, Andrea; Shridhar, Ravi; White, Sarah B.; Rilling, William S.; Boyer, Brendan; Kauffman, Shannon; Kwan, Sharon; Padia, Siddarth A.; Gates, Vanessa L.; Mulcahy, Mary Frances; Kircher, Sheetal Mehta; Nimeiri, Halla S; Benson III, Al B; Salem, Riad.

In: Journal of Nuclear Medicine, Vol. 57, No. 5, 01.05.2016, p. 665-671.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 90Y radioembolization of colorectal hepatic metastases using glass microspheres

T2 - Safety and survival outcomes from a 531-patient multicenter study

AU - Hickey, Ryan M

AU - Lewandowski, Robert J

AU - Prudhomme, Totianna

AU - Ehrenwald, Eduardo

AU - Baigorri, Brian

AU - Critchfield, Jeffrey

AU - Kallini, Joseph

AU - Gabr, Ahmed

AU - Gorodetski, Boris

AU - Geschwind, Jean Francois

AU - Abbott, Andrea

AU - Shridhar, Ravi

AU - White, Sarah B.

AU - Rilling, William S.

AU - Boyer, Brendan

AU - Kauffman, Shannon

AU - Kwan, Sharon

AU - Padia, Siddarth A.

AU - Gates, Vanessa L.

AU - Mulcahy, Mary Frances

AU - Kircher, Sheetal Mehta

AU - Nimeiri, Halla S

AU - Benson III, Al B

AU - Salem, Riad

PY - 2016/5/1

Y1 - 2016/5/1

N2 - 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 90Y 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 90Y microspheres at 8 institutions, making it the largest 90Y study for patients with colorectal liver metastases. Methods: Data were retrospectively compiled from 8 institutions for all 90Y 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 90Y 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 90Y 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 90Y 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. 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

AB - 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 90Y 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 90Y microspheres at 8 institutions, making it the largest 90Y study for patients with colorectal liver metastases. Methods: Data were retrospectively compiled from 8 institutions for all 90Y 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 90Y 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 90Y 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 90Y 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. 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

KW - Colorectal metastases

KW - Radioembolization

KW - Survival

KW - Y

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U2 - 10.2967/jnumed.115.166082

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