Colorectal Cancer Patients’ Liver Metastases Treated Effectively with Radioembolization Therapy

For patients who do not respond to standard first-line and second-line therapy for colorectal cancer liver metastases (also known as salvage patients), radioembolization treatment utilizing Y-90 microspheres could extend survival, according to new findings. A comprehensive review revealed that approximately 50% of salvage patients have an overall survival of more than 12 months after this nuclear medicine therapy.

A structured review was performed by researchers to gather all available evidence on radioembolization for the specific group of patients with colorectal cancer liver metastases. “Although quite some reviews are printed on the subject of radioembolization, we felt that a structured and comprehensive review on survival and response data for these patients was lacking,” said Charlotte E.N.M. Rosenbaum, PhD, from the department of radiology and nuclear medicine, University Medical Center Utrecht (The Netherlands), and lead author of the study.

The investigators reviewed a total of 13 articles on Y-90 radioembolization as a monotherapy and 13 articles on Y-90 radioembolization combined with chemotherapy. Disease control rates (i.e., complete response, partial response and stable disease) in the studies ranged from 29%–90% in the monotherapy studies, which involved 901 patients. In the studies in which Y-90 radioembolization was combined with chemotherapy, involving 472 patients, disease control rates ranged from 59%–100%.

“From the studies included in this systematic review, survival proportions of approximately 50% were found. Therefore, in this group of salvage colorectal cancer liver metastases patients who otherwise have no regular treatment options and a life expectancy of less than six months, Y-90 radioembolization seems to be a hopeful treatment option,” noted Dr. Rosenbaum. “Our paper shows all published data on this subject from the first randomized trial onwards. Furthermore, we have determined 12-month survival proportions for all included articles to provide a better overview and to better allow for comparisons. Finally, this overview of the literature shows which topics have not been the focus of much research and may thus be interesting for further work.”

The study’s findings were published in the November 2013 issue of the Journal of Nuclear Medicine.

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University Medical Center Utrecht