title: Radioembolization with Yttrium-90 microspheres (SIRT) in pancreatic cancer patients with liver metastases: efficacy, safety and prognostic factors.
abstract: OBJECTIVE
  To analyze the clinical efficacy of (90)Y radioembolization in liver metastases from pancreatic cancer, to describe treatment toxicities and to identify biomarkers as predictors of outcome.
  
  
  METHODS
  Data from 19 pancreatic cancer patients (9 females/10 males) who had received (90)Y radioembolization for metastatic liver disease between 06/2004 and 01/2011 were analyzed retrospectively.
  
  
  RESULTS
  The median age at (90)Y radioembolization was 63 years (range 43-77). In 16 patients, previous palliative gemcitabine-based chemotherapy was given for metastatic disease. Objective response in the liver after (90)Y radioembolization was 47%. Median local progression-free survival in the liver was 3.4 months (range 0.9-45.0). Median overall survival (OS) was 9.0 months (range 0.9-53.0) and 1-year survival was 24%. Cox regression models for baseline biomarkers at (90)Y radioembolization revealed correlations of increased carbohydrate antigen 19-9 (p = 0.02) and C-reactive protein (p = 0.03) with shorter OS. Short-term adverse events (nausea, vomiting, fatigue, fever and abdominal pain) did not exceed grade 3. As long-term adverse events, liver abscesses, gastroduodenal ulceration, cholestasis and cholangitis, ascites and spleen infarction were observed.
  
  
  CONCLUSIONS
  (90)Y radioembolization is able to induce an encouraging local response rate of liver metastases of pancreatic cancer patients. Most short-term toxicities are manageable; however, patients should be followed up carefully for severe long-term toxicities.
authors.affiliation: Department of Medical Oncology, Klinikum Grosshadern and Comprehensive Cancer Center, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Michl
authors.forename: A R
authors.initials: AR
authors.lastname: Haug
authors.forename: T F
authors.initials: TF
authors.lastname: Jakobs
authors.forename: P
authors.initials: P
authors.lastname: Paprottka
authors.forename: R-T
authors.initials: RT
authors.lastname: Hoffmann
authors.forename: P
authors.initials: P
authors.lastname: Bartenstein
authors.forename: S
authors.initials: S
authors.lastname: Boeck
authors.forename: M
authors.initials: M
authors.lastname: Haas
authors.forename: R P
authors.initials: RP
authors.lastname: Laubender
authors.forename: V
authors.initials: V
authors.lastname: Heinemann
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015021:Yttrium Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D015021:Yttrium Radioisotopes