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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/21805

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
Citation: 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.
URI: http://hdl.handle.net/1942/21805
DOI: 10.3109/0284186X.2015.1101151
ISI #: 000372125400014
ISSN: 0284-186X
Category: A1
Type: Journal Contribution
Validation: ecoom, 2017
Appears in Collections: Research publications

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