title: Outcomes of Therasphere Radioembolization for Colorectal Metastases.
abstract: BACKGROUND
  The liver is the most common site for colorectal cancer (CRC) metastases. Radioembolization with yttrium-90 (Y90) represents an alternative approach in the management of unresectable hepatic colorectal metastases. The objective of this study was to evaluate outcomes after treatment with Y90.
  
  
  METHODS
  A retrospective review of patients undergoing Y90 glass microsphere treatment for metastatic CRC from 2009 to 2013 was conducted. Multivariable analysis (MVA) of factors related to overall survival (OS) was performed using the Cox proportional hazard and OS estimates were calculated using the Kaplan-Meier method.
  
  
  RESULTS
  We identified 68 patients. Median and 2-year OS were 11.6 months and 34%. For patients with ≤ 25% hepatic burden of disease (HBD) and 1 chemotherapy regimen, 2-year OS was 63%. Median and 2-year OS for patients with ≤ 25% versus > 25% HBD were 19.6 months and 42% versus 3.4 months and 0% (P < .0001). Univariate analysis revealed that higher HBD, ≥ 3 lines of chemotherapy received, and higher carcinoembryonic antigen (CEA) were found to be significant predictors of worse OS. MVA revealed age, > 25% HBD, ≥ 3 lines of chemotherapy, and higher CEA were independently prognostic for increased mortality, and resected status of the primary tumor was associated with decreased mortality. The presence of extrahepatic metastases was not prognostic. Toxicities were mild and only 5 patients experienced Grade 3/4 biochemical toxicity.
  
  
  CONCLUSIONS
  Yttrium-90 was associated with acceptable OS with minimal morbidity in this series. Minimal exposure to chemotherapy and low HBD were found to be associated with better OS, however, even patients with chemotherapy-refractory disease received a benefit from treatment.
authors: Department of Surgery, Moffitt Cancer Center, Tampa, FL. Electronic address: andrea.abbott@moffitt.org.
authors: Andrea M
authors: AM
authors: Abbott
authors: Department of Medical Oncology, Moffitt Cancer Center, Tampa, FL.
authors: Richard
authors: R
authors: Kim
authors: Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL.
authors: Sarah E
authors: SE
authors: Hoffe
authors: Department of Interventional Radiology, Rush Medical Center, Chicago, IL.
authors: Bulent
authors: B
authors: Arslan
authors: Department of Interventional Radiology, Moffitt Cancer Center, Tampa, FL.
authors: Ben
authors: B
authors: Biebel
authors: Department of Interventional Radiology, Moffitt Cancer Center, Tampa, FL.
authors: Junsung
authors: J
authors: Choi
authors: Department of Interventional Radiology, Moffitt Cancer Center, Tampa, FL.
authors: Ghassan
authors: G
authors: El-Haddad
authors: Department of Interventional Radiology, Moffitt Cancer Center, Tampa, FL.
authors: Bela
authors: B
authors: Kis
authors: Department of Interventional Radiology, Moffitt Cancer Center, Tampa, FL.
authors: Jennifer
authors: J
authors: Sweeney
authors: Department of Surgery, Sarasota Memorial Hospital, Sarasota, FL.
authors: Kenneth L
authors: KL
authors: Meredith
authors: Department of Medical Oncology, Moffitt Cancer Center, Tampa, FL.
authors: Khaldoun
authors: K
authors: Almhanna
authors: Department of Medical Oncology, Moffitt Cancer Center, Tampa, FL.
authors: Jonathan
authors: J
authors: Strosberg
authors: Department of Surgery, Moffitt Cancer Center, Tampa, FL.
authors: David
authors: D
authors: Shibata
authors: Department of Biostatistics, Moffitt Cancer Center, Tampa, FL.
authors: William J
authors: WJ
authors: Fulp
authors: Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL.
authors: Ravi
authors: R
authors: Shridhar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000473:pathology*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage*
chemical_list: D000970:Antineoplastic Agents; D015021:Yttrium Radioisotopes
keywords: Colon cancer; Liver metastases; Radiation therapy; Regional therapy; Yttrium-90