title: Robust evidence for long-term survival with90Y radioembolization in chemorefractory liver-predominant metastatic colorectal cancer.
abstract: OBJECTIVE
  Our aim was to provide further evidence for the efficacy/safety of radioembolization using yttrium-90-resin microspheres for unresectable chemorefractory liver metastases from colorectal cancer (mCRC).
  
  
  METHODS
  We followed 104 consecutively treated patients until death. Overall survival (OS) was calculated from the day of the first radioembolization procedure. Response was defined by changes in tumour volume as defined by Response Evaluation Criteria in Solid Tumours (RECIST) v1.0 and/or a ≥30 % reduction in serum carcinoembryonic antigen (CEA) at 3 months.
  
  
  RESULTS
  Survival varied between 23 months in patients who had a complete response to prior chemotherapy and 13 months in patients with a partial response or stable disease. Median OS also significantly improved (from 5.8 months to 17.1 months) if response durability to radioembolization extended beyond 6 months. Patients with a positive trend in CEA serum levels (≥30 % reduction) at 3 months post-radioembolization also had a survival advantage compared with those who did not: 15.0 vs 6.7 months. Radioembolization was well tolerated. Grade 3 increases in bilirubin were reported in 5.0 % of patients at 3 months postprocedure.
  
  
  CONCLUSIONS
  After multiple chemotherapies, many patients still have a good performance status and are eligible for radioembolization. This single procedure can achieve meaningful survivals and is generally well tolerated.
  
  
  CONCLUSIONS
  • After multiple chemotherapies, many patients are still eligible for radioembolization (RE). • RE can achieve meaningful survival in patients with chemorefractory liver-predominant metastatic colorectal cancer (mCRC). • Tumour responsiveness to prior systemic treatments is a significant determinant of overall survival (OS) after RE. • Radioembolization in patients with a good performance status is generally well tolerated.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Barmherzige Brueder Munich, Romanstraße 93, 80639, Munich, Germany. tobias.jakobs@barmherzige-muenchen.de.
authors.forename: T F
authors.initials: TF
authors.lastname: Jakobs
authors.affiliation: Department of Clinical Radiology, LMU - University of Munich, Munich, Germany.
authors.forename: K J
authors.initials: KJ
authors.lastname: Paprottka
authors.affiliation: Department of Clinical Radiology, LMU - University of Munich, Munich, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Raeßler
authors.affiliation: Department of Clinical Radiology, LMU - University of Munich, Munich, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Strobl
authors.affiliation: Department of Nuclear Medicine, LMU - University of Munich, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Lehner
authors.affiliation: Department of Nuclear Medicine, LMU - University of Munich, Munich, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Ilhan
authors.affiliation: Department of Clinical Radiology, LMU - University of Munich, Munich, Germany.
authors.forename: C G
authors.initials: CG
authors.lastname: Trumm
authors.affiliation: Department of Nuclear Medicine, LMU - University of Munich, Munich, Germany.
authors.forename: W P
authors.initials: WP
authors.lastname: Fendler
authors.affiliation: Department of Clinical Radiology, LMU - University of Munich, Munich, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Sommer
authors.affiliation: Department of Clinical Radiology, LMU - University of Munich, Munich, Germany.
authors.forename: P M
authors.initials: PM
authors.lastname: Paprottka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000494:pharmacology*; D001918:Brachytherapy / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000628:therapy; D019008:Drug Resistance, Neoplasm; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage*
chemical_list: D000970:Antineoplastic Agents; D015021:Yttrium Radioisotopes
keywords: Liver metastases; Palliative care; Radioisotope brachytherapy; Safety; Treatment efficacy