title: Survival and tolerability of liver radioembolization: a comparison of elderly and younger patients with metastatic colorectal cancer.
abstract: OBJECTIVE
  To evaluate the outcomes among elderly (≥70 years) and younger patients (<70 years) with liver-dominant metastatic colorectal cancer (mCRC) who received radioembolization (RE) as salvage therapy.
  
  
  METHODS
  A retrospective review of 107 consecutive patients with unresectable mCRC treated with RE after failing first- and second-line chemotherapy.
  
  
  RESULTS
  From 2002 to 2012, 44 elderly and 63 younger (<70 years) patients received RE. Patients had similar previous extensive chemotherapy and liver-directed interventions. Using modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria, either a stable or a partial radiographical response was seen in 65.8% of the younger compared with 76.5% of the elderly patients. RE was equally well tolerated in both groups and common procedure-related adverse events were predominantly grade 1-2 and of short duration. No significant difference was found with regard to overall median survival between younger [8.4 months; 95% confidence interval (CI) = 6.2-10.6] or elderly patients (8.2 months; 95% CI = 5.9-10.5, P = 0.667). The presence of extrahepatic disease at the time of RE was associated with a significantly worse median survival in both groups.
  
  
  CONCLUSIONS
  Radioembolization appears to be as well tolerated and effective for the elderly as it is for younger patients with mCRC. Age alone should not be a discriminating factor for the use of radioembolization in the management of mCRC patients.
authors.affiliation: Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Samer
authors.initials: S
authors.lastname: Tohme
authors.forename: Daniel
authors.initials: D
authors.lastname: Sukato
authors.forename: Gary W
authors.initials: GW
authors.lastname: Nace
authors.forename: Albert
authors.initials: A
authors.lastname: Zajko
authors.forename: Nikhil
authors.initials: N
authors.lastname: Amesur
authors.forename: Philip
authors.initials: P
authors.lastname: Orons
authors.forename: Didier
authors.initials: D
authors.lastname: Chalhoub
authors.forename: James W
authors.initials: JW
authors.lastname: Marsh
authors.forename: David A
authors.initials: DA
authors.lastname: Geller
authors.forename: Allan
authors.initials: A
authors.lastname: Tsung
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D016879:Salvage Therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals