title: Safety and Efficacy of Radioembolization in Elderly (≥ 70 Years) and Younger Patients With Unresectable Liver-Dominant Colorectal Cancer.
abstract: BACKGROUND
  The effects of advancing age on clinical outcomes after radioembolization (RE) in patients with unresectable liver-dominant metastatic colorectal cancer (mCRC) are largely unknown.
  
  
  METHODS
  This study was a retrospective analysis of 160 elderly (≥ 70 years) and 446 younger (< 70 years) consecutive patients from 11 US centers who received RE using ytrrium-90 ((90)Y) resin microspheres ((90)Y radioembolization [(90)Y-RE]) between July 2002 and December 2011. A further analysis was conducted in 98 very elderly patients (≥ 75 years). Statistical analyses of safety, tolerability, and overall survival were conducted.
  
  
  RESULTS
  Mean ages (± standard deviation) in the younger (< 70 years), elderly (≥ 70 years), and very elderly (≥ 75 years) cohorts were 55.9 ± 9.4 years, 77.2 ± 4.8 years, and 80.2 ± 3.8 years, respectively. Overall survival was similar between elderly and younger patients: 9.3 months (95% confidence interval [CI], 8.0-12.1) and 9.7 months (95% CI, 9.0-11.4) (P = .335). There were no differences between cohorts for any grade adverse events (P = .433) or grade 3+ events (P = .482). Analysis of patients ≥ 75 years and < 75 years confirmed similar overall survival (median, 9.3 months vs. 9.6 months, respectively; P = .987) and grade 3+ events (P = .398) or any adverse event (P = .158) within 90 days of RE.
  
  
  CONCLUSIONS
  For patients with unresectable liver-dominant mCRC who meet eligibility criteria for RE, (90)Y-RE microspheres appear to be effective and well-tolerated, regardless of age. Criteria for selecting patients for RE should not include age for exclusion from this potentially beneficial intervention.
authors.affiliation: Cancer Centers of North Carolina, Cary, NC, and Sarah Cannon Research Institute, Nashville, TN. Electronic address: andrew.kennedy@scresearch.net.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Kennedy
authors.affiliation: Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: David S
authors.initials: DS
authors.lastname: Ball
authors.affiliation: Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Cohen
authors.affiliation: Radiology Associates of Hollywood, Pembroke Pines, FL.
authors.forename: Michael
authors.initials: M
authors.lastname: Cohn
authors.affiliation: James Graham Brown Cancer Center, University of Louisville, Louisville, KY.
authors.forename: Douglas
authors.initials: D
authors.lastname: Coldwell
authors.affiliation: Fairfax Radiological Consultants, Fairfax, VA.
authors.forename: Alain
authors.initials: A
authors.lastname: Drooz
authors.affiliation: Abbott Northwestern Hospital, Minneapolis, MN.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ehrenwald
authors.affiliation: Inova Fairfax Hospital, Annandale, VA.
authors.forename: Samir
authors.initials: S
authors.lastname: Kanani
authors.affiliation: University of California, San Diego Health Sciences, San Diego, CA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Rose
authors.affiliation: Radiology Imaging Associates, Englewood, CO.
authors.forename: Charles W
authors.initials: CW
authors.lastname: Nutting
authors.affiliation: University of Maryland Medical Center, Baltimore, MD.
authors.forename: Fred M
authors.initials: FM
authors.lastname: Moeslein
authors.affiliation: Oakland University William Beaumont School of Medicine, Royal Oak, MI.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Savin
authors.affiliation: Cancer Centers of North Carolina, Cary, NC.
authors.forename: Sabine
authors.initials: S
authors.lastname: Schirm
authors.affiliation: Fox Chase Cancer Center, Philadelphia, PA.
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Putnam
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Navesh K
authors.initials: NK
authors.lastname: Sharma
authors.affiliation: Charlotte Radiology, Charlotte, NC.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
chemical_list: D015021:Yttrium Radioisotopes
keywords: Advanced; Brachytherapy; Metastases; SIRT; Yttrium-90