title: Multimodal sequential approach in colorectal cancer liver metastases: hepatic resection after yttrium-90 selective internal radiation therapy and cetuximab rescue treatment.
abstract: Synchronous or metachronous liver metastases occur in up to one-third of patients with colorectal cancer and are associated with a poor prognosis. Many evidences have shown that surgical resection can be curative, with 5-year survival rates ranging from 37% to 50%, but many patients are ineligible for surgery because of multiple liver lesions, bilobar distribution of liver metastases, or the presence of widespread extrahepatic disease. The management of unresectable liver metastases includes many therapeutic options such as systemic chemotherapy, selective internal radiation therapy (SIRT) with yttrium-90 (Y-90), targeted therapy, and surgery. These treatments can be integrated into a sequential multimodal approach to increase the resection rate. We present a case in which such an approach was put into practice. The favorable result suggests that SIRT, along with systemic chemotherapy and surgery, is a valid treatment option for unresectable colorectal liver metastases.
authors.affiliation: Medical Oncology Unit, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Pini
authors.forename: Carmine
authors.initials: C
authors.lastname: Pinto
authors.forename: Bruna
authors.initials: B
authors.lastname: Angelelli
authors.forename: Emanuela
authors.initials: E
authors.lastname: Giampalma
authors.forename: Annabella
authors.initials: A
authors.lastname: Blotta
authors.forename: Francesca
authors.initials: F
authors.lastname: Di Fabio
authors.forename: Donatella
authors.initials: D
authors.lastname: Santini
authors.forename: Rita
authors.initials: R
authors.lastname: Golfieri
authors.forename: Andrea Angelo
authors.initials: AA
authors.lastname: Martoni
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001918:Brachytherapy / Q000379:methods; D000068818:Cetuximab; D015179:Colorectal Neoplasms / Q000473:pathology*; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D008297:Male; D016879:Salvage Therapy / Q000379:methods; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D015021:Yttrium Radioisotopes; D000068818:Cetuximab