90Y radioembolization of colorectal hepatic metastases using glass microspheres: Safety and survival outcomes from a 531-patient multicenter study

Ryan 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 MulcahySheetal Kircher, Halla Nimeiri, Al B. Benson, Riad Salem

Research output: Contribution to journalArticle

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

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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

  • Y
  • Colorectal metastases
  • Radioembolization
  • Survival

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

90Y radioembolization of colorectal hepatic metastases using glass microspheres : Safety and survival outcomes from a 531-patient multicenter study. / Hickey, Ryan; 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; Kircher, Sheetal; Nimeiri, Halla; Benson, Al B.; Salem, Riad.

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

Research output: Contribution to journalArticle

Hickey, R, 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, M, Kircher, S, Nimeiri, H, Benson, 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
Hickey, Ryan ; 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 ; Kircher, Sheetal ; Nimeiri, Halla ; Benson, 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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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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T1 - 90Y radioembolization of colorectal hepatic metastases using glass microspheres

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

AU - Hickey, Ryan

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

AU - Kircher, Sheetal

AU - Nimeiri, Halla

AU - Benson, Al B.

AU - Salem, Riad

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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.

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KW - Radioembolization

KW - Survival

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